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Systemic inflammatory response syndrome (SIRS) following unregulated IV administration, presenting with fever above 41 degrees Celsius, acute liver injury, and clotting abnormalities, is also documented in a 2025 case report

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[DOI] [PMC free article] [PubMed] [Google Scholar] 5.Jakubovic BD, Sawires HF, Adam DN

Additional oral or sublingual B12 supplementation is generally safe alongside the blend, though likely unnecessary for most patients since the injection provides direct B12 delivery

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