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Effects can be felt in hours to days, not weeks

During a loading phase of 10 units five times weekly 50 units per week a single vial covers roughly four weeks

Froese D.S., Gravel R.A

Decrease dose if: Experiencing consistent side effects (headaches, fatigue, GI disturbance), achieving satisfactory results at current dose with no need for escalation, or cost considerations favor using minimum effective dose

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One common cause of persistent fatigue and low energy that we often see in our practice is Vitamin B12 deficiency