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it can lead to severe adverse events, such as respiratory distress

Importantly, gradual titration over 20 weeks greatly reduces the incidence and severity of GI side effects

However, there are no large-scale, long-term human safety trials

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These approaches may improve stability, absorption, and lymphatic transport

These findings reinforce the importance of continued monitoring, early detection, and intervention strategies to possibly mitigate the growing burden of vitamin B12 deficiency in both public and private healthcare settings (23)