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B12 plays a role in cellular energy metabolism, and some providers argue that ensuring optimal B12 levels helps mitigate treatment-related fatigue, particularly in patients who were subclinically deficient before starting

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Patients typically experience results for a year, though some find they want a boost around the 6 month mark, especially for those who had more severe symptoms before treatment

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While small-scale studies are ongoing, the transition to adequately powered trials with comparison groups remains a research priority for advancing regulatory policy and understanding