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Note that you can have B12 deficiency symptoms long before it progresses to anemia

Touti, F., Lautrette, G., Johnson, K.D., Delaney, J.C., Wollacott, A., Tissire, H., et al., ChemBioChem , 2018, vol

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Women of childbearing age should use effective contraception during treatment and discontinue the medication if pregnancy occurs

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