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Common signs include: Fatigue and weakness Numbness or tingling in the hands and feet Difficulty walking or balance problems Mood changes, such as depression or anxiety Cognitive difficulties, including memory loss or confusion If not treated, a B12 deficiency can cause serious problems

High dose oral cobalamin may be a suitable alternative in selective cases, where intramuscular injections are not tolerated and compliance is not a problem

Its analytical verification, purity standards, and quality-control testing support its use in controlled experimental environments

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