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The incidence of this behaviour is increasing ..This appears to be due to a cost saving exercise and largely happens without any prior consultation with individual patients to discuss their needs

Monthly injections are well suited to maintenance, keeping already-healthy levels healthy, but they are often not enough during the correction phase for someone who is significantly deficient

The doses in compounded combinations may not provide adequate amounts for someone with surgical absorption limitations

A post-RYGB patient with serum B12 below 100 pmol/L may need eight to twelve weeks of aggressive repletion, sometimes with intramuscular injections, before I am comfortable operating