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They can also recommend alternative supplementation methods, such as oral supplements or patches, if injections are not necessary or appropriate for your situation
Cautious use of parenteral cyanocobalamin is also recommended in patients with renal impairment, including premature neonates, because of the possibility of greater aluminum accumulation, which may cause central nervous system and bone toxicity
Maintenance phase: Once your levels are healthy and symptoms improve, we move to a maintenance schedule, which might be a monthly shot or a return to high-dose oral supplements if your absorption allows
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