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Doctors choose hydroxocobalamin based on the patients needs and how they react to treatment

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Stores sit mainly in the liver and last years, so deficiency develops slowly and quietly, which is precisely why it gets missed

These include pain, swelling, itching, bruising, and redness

[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes

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