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24 25 Some patients may experience recurrence or worsening of symptoms when the interval between injections is extended or extended too quickly, and report that continuation of frequent intramuscular hydroxocobalamin injections, varying between twice weekly and once every three to four weeks, 65 is needed to remain asymptomatic

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Vitamin B 12 deficiency can develop with heavy regular use of nitrous oxide N 2 O, also known as "laughing gas", used for anaesthesia in a clinical setting or as a propellant gas, commonly abused as a recreational drug

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