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I don't want to be hurting her, but need to keep up with the B12 as she has suffered permanent neurological damage where she was misdiagnosed with MS and then left with no support for years

Not all treatments are equal

It has a different side effect profile than GLP-1 agonists, though it may cause nausea, headache, and constipation

Do not store it on its side, as this increases the surface area of solution exposed to air in the vial headspace, accelerating oxidative degradation