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Hydroxocobalamin 1mg is the standard UK formulation, typically administered every two to three months for maintenance therapy Self-administration requires GP prescription, competency training from practice nurses, and demonstration of proper injection technique Common injection sites include the thigh (vastus lateralis) for both intramuscular and subcutaneous administration with site rotation essential Serious side effects are rare but anaphylaxis requires immediate 999 call

Glycosaminoglycan synthesis also increased by approximately 70%, contributing to improved skin hydration and volume

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The cortisol response from anxiety about the scale creates a feedback loop that makes the problem worse