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Acknowledgments The authors thank the contributions of all investigators whose research informed this study and FigDraw for figure support

I'm injections for 2 months now, my GP and GI still refuse to run my blood test saying it is not needed The more injections I get (I started injecting myself every 48 hours 500 mcg hydroxycobalamin because 1000 mcg was unbearable to deal with feeling sick for days) the more pain and symptoms increase