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Nevertheless, in cases of severe deficiency with neurological sequelae, we suggest that IM B12 is used in the first instance to replenish body stores with the treatment regimen, including dosage and formulation, optimised to keep the patient free of symptoms and tailored to the metabolic response of not only plasma B12 levels, but also confirmatory testing of homocysteine, methionine, and methylmalonic acid levels

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The board began to shake and flash purple