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Contact your GP if you experience: No improvement after 46 weeks of treatment : Whilst neurological symptoms may take longer to resolve, you should notice some improvement in energy levels or general wellbeing within this timeframe

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It can still be obtained through licensed compounding pharmacies under physician supervision, which is how Beyond Stem Cells sources it

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It can be prescribed by a licensed practitioner and compounded by a 503A pharmacy for individual patients, though the regulatory landscape has been evolving