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Infection signs, worsening injuries, or unusual neurologic symptoms need symptom-based review

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[3] [9] Those with neurological symptoms may require more frequent dosing initially (alternate days until improvement) followed by two-monthly maintenance

it can be taken as a pill or under the tongueis when there is a deficiency that can be caused by pernicious anemia, celiac or Crohns disease, or weight loss procedures such as gastric bypass surgery, which interferes with the bodys ability to extract vitamins from food