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This dual modulation likely explains the neuroprotective effects in animal models and the neuropsychiatric side effects some users report at higher doses

"Vitamin B12 deficiency mimicking acute leukemia"

PLoS ONE 8 , e74083 (2013)

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In physician-supervised protocols, it is prescribed for cognitive decline support, neurological rehabilitation, and executive function enhancement

Pregnant or breastfeeding patients should discuss with their obstetric provider before starting this injection, and ensure all healthcare team members are aware, so that vitamin levels and any pregnancy-related effects can be monitored appropriately