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Vitamin B12 cyanocobalamin supplements are made by using bacteria grown on a cobalt-enriched medium in a laboratory, producing vitamin B12 as natural as found in dairy, eggs, and meats

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For patients whose symptoms significantly impact quality of life, healthcare providers may consider evidence-based pharmacologic options such as certain SSRIs/SNRIs, gabapentin, oxybutynin, or fezolinetant (FDA-approved for moderate to severe vasomotor symptoms)