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Important safety considerations include common adverse effects such as gastrointestinal symptoms (nausea, vomiting, diarrhea), which occur in 20-40% of patients but typically diminish with continued use

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[3] Consider the benefits of breastfeeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition

Some people have lichen planus inside their mouth, genital region, scalp, and nails

Many patients notice improved energy levels and reduced fatigue within 12 weeks of starting intramuscular B12 injections