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This may include people with active cancer concerns, immune disorders, uncontrolled chronic illness, pregnancy or plans for pregnancy, complex medication regimens, bleeding disorders, severe allergies, kidney or liver concerns, unexplained symptoms, or a history of poor reactions to injectable products
A consistent upward trend of more than 15 beats per minute above baseline, or any reading consistently above 95 at rest, warrants a pause in dose escalation and consultation with a physician
These symptoms may suggest inadequate B12 replacement, concurrent iron or folate deficiency, or alternative haematological conditions requiring investigation
