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[1] [6] Severe deficiencies may include symptoms of reduced heart function, suppression of bone marrow, as well as more various severe neurological symptoms possibly including sensory loss, abnormal balance and reflexes, memory and consciousness impairment, smell and taste problems, depression, irritability, confusion, and psychosis
Extreme deficits (800-1,000 calories below maintenance) are unnecessary and counterproductive because they increase muscle catabolism and metabolic adaptation
The vitamin is administered in the office via injections
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