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For severe cases, a bigger dose might be given first, followed by smaller doses later

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But for others, a regularly scheduled B12 plan is the best way to keep all systems up and running

The interaction between the two is calibrated at intake to ensure they are working on complementary rather than overlapping pathways

If nausea persists beyond 3-4 weeks on a stable dose, consider reducing to the previous dose level and attempting re-escalation more gradually after 4-6 weeks