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There are no other absolute contraindications reported for hydroxocobalamin use in deficiency states, but caution is advised in individuals with conditions such as early Lebers optic neuropathy (a rare hereditary optic atrophy) due to the theoretical risk of worsening vision

Five distinct metabolic pathways activated simultaneously

You should get medical help right away if this happens

The authors also noted that further optimisation was needed, including work relating to high clearance in mice and off-target activity against monoamine oxidase A

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However, leading a healthy lifestyle helps the injections work better