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The most commonly reported effects during the initiation phase include: Injection site reactions: Mild redness, itching, or a small bump at the site that resolves within hours

Individuals with conditions impairing B12 absorption, such as pernicious anemia or gastrointestinal disorders

Figure 2 4.4 Hyperlipidemia Alterations in lipid metabolism, characterized by an increase in cholesterol, triglycerides, and low-density lipoproteins (LDL), are one of the major complications of NS that frequently go under-recognized