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Extra provider scrutiny is warranted for patients with hepatic impairment (Child-Pugh B or C), significant renal impairment (eGFR below 30), high-dose zinc supplementation (above 50 mg/day), active infection at the intended injection site, or age under 18

The most consistently documented side effect of excessive B12 is dermatological reactions, particularly acne-like eruptions and rosacea flare-ups

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Antioxidants help neutralize free radicals produced by UV exposure, but they should complementnot replacesun protection

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