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Ethical approval The study protocol was approved by appropriate health authorities according to local guidelines and by the Institutional Review Board/Independent Ethics Committee Institutional Review Board, listed in the Supplementary Appendix

Real Benefits of B12 Injections Most people try B12 injections because they feel tired

Government Plans (Medicare Advantage, Managed Medicaid, FFS Medicare): Representing about 50% of insured lives in the U.S

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Mild headache, dry mouth, brief gastrointestinal discomfort, or tingling sensations have been reported by a smaller subset of patients

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