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It is more stable, longer-lasting and clinically superior to cyanocobalamin a cheaper synthetic form widely used in beauty salons and non-medical clinics that contains a small amount of cyanide which the body must detoxify

Nausea, diarrhea, and constipation affect significant percentages of users during dose escalation

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The most commonly cited starting protocol in the medical literature and clinical practice involves 250 micrograms administered once daily for acute injury, stepping up to 500 micrograms daily if response is insufficient after one to two weeks