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The extent to which vitamin B 12 deficiency contributes to the symptoms of these patients is not clearly illustrated in the studies, although the patients’ mean baseline vitamin B 12 levels were within normal range in two studies.(10,11) Furthermore, as no serious adverse events were reported in most of the studies, no extended follow-up of patients to assess for harm due to supplementation was conducted
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In some cases, high-dose daily oral B12 supplements (typically 1000 µg daily) can also be used as an effective alternative or addition for maintenance therapy [9] [10]
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