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Oral supplements require higher doses because only approximately 1% is absorbed passively when intrinsic factor is impaired, making injections the most reliable method for pernicious anaemia and malabsorption conditions

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Reconstitution Steps Remove the vial from freezer storage (20 C / 4 F) and let it equilibrate at room temperature for 1520 minutes

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This allows assessment of tolerance before increasing

Would it not set off alarm bells at the clinic