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Appetite, 31(3), 367380
The vial rubber stopper is damaged Repeated punctures through the same spot can core the rubber stopper, creating small rubber particles that fall into the solution
It's just one of the causes of B12 deficiency
Many people seem to experience symptoms like those you mention - where it has been mentioned in posts my memory is that the individuals concerned report the sleepiness as something that continues as they move into maintenance shots
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