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A 2022 CADTH review 1 performed at the request of GPAC found: No studies evaluating the clinical utility of B 12 testing in people with suspected B 12 deficiency

This does not indicate a short-filled vial

Therefore the old saying, Out of sight, out of mind definitely applies to this situation

These factors suggest starting slightly higher than the minimum effective clinical dose to account for real-world variability

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It's popular in biohacking circles and often pops up in patient consults, but the FDA hasn't approved it for human therapy