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According to NICE Clinical Knowledge Summary guidance, patients with neurological involvement should receive more intensive initial treatment to optimise recovery potential

Clean the injection site with antiseptic

Reticulocytosis (increased production of immature red blood cells) typically begins by day 3-4 of starting treatment, indicating active bone marrow recovery

Common signs include persistent fatigue (even after a full nights sleep), brain fog, mood swings or irritability, numbness or tingling in the hands or feet, and a weakened immune system

Folate is abundant in fresh, green feeds, but processing feed rapidly destroys it