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Even if lab values normalize, ongoing fatigue, poor sleep, or nerve discomfort may warrant treatment continuation or adjustment

Proper diagnostic tests use serum B12, methylmalonic acid, and homocysteine levels to provide accurate diagnosis when standard tests fail

Today it is available only by prescription, compounded by state-licensed 503A pharmacies or FDA-registered 503B outsourcing facilities, neither of which is independently reviewed or approved by the FDA as a finished drug product, most commonly prescribed off-label for adult GH decline or wellness/anti-aging use

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