These signs include fatigue, weakness, constipation, reduced appetite, weight loss, along with numbness and tingling sensations in the extremities
In the UK, hydroxocobalamin is the standard form used for intramuscular injections, and routine monitoring of serum B12 levels during replacement therapy is generally not required once treatment is established
As such, any clinical use should be framed as exploratory and hypothesis generating rather than standard of care
Reality : Gradual potency loss
All patients underwent a standardized education and behavioral modification program (EBMP), including increased understanding of the bladder and voiding, techniques to manage stress and pain symptoms, management of fluid intake, bladder training and urge suppression, as well as avoidance of food and beverage "symptom triggers." Forty-five per cent of patients (n=136) assigned to the EBMP with placebo group were markedly or moderately improved on the Global Response Assessment, suggesting the significant benefits of self-care practices and behavioral modification even without the active drug
