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Before the year 2000, little information was available on genetic susceptibility to DILI

We know that macrocytosis is a very, very late stage of B12 deficiency and that severely deficient patients may not present with this sign, the administration of folic acid also masks macrocytosis by normalising the size of the blood cells

Generally well-tolerated with minimal reports of mild headaches or nasal irritation

Without enough B12, red blood cells can become large and irregular (megaloblastic anemia), which reduces their ability to carry oxygen efficiently

Never inject the bacteriostatic water directly onto the powder cake