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Its the difference between clean data and a confounded experiment
Unlike deficiency states, which produce well-characterised neurological and haematological symptoms, there is no clearly defined clinical syndrome associated with B12 excess from supplementation alone
Think about it this way: a single speculative injection at a private clinic could set you back 50
However, there are many unusual symptoms associated with vitamin B12 deficiency, and most will disappear after taking vitamin B12 long enough to get the stores up to a normal amount and have maintained stable levels of vitamin B12
Kang et al., 2018
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