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The principle of stepwise management is preferred, where treatment is escalated or modified based on individual patient response rather than combining multiple pharmacological agents simultaneously

The body can identify with it and such

Symptoms of real deficiency include fatigue, tingling or numbness in hands and feet, memory and concentration issues, mouth ulcers and pale skin, and a GP blood test is the only reliable way to confirm it

The guidance for neurological symptoms, recommending every-other-day injections, further highlights that the standard maintenance dose is not universally sufficient

We regularly see patients with injection-site infections and erratic dosing from product bought online