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It also has a real downside: roughly 40 percent of patients in the clinical trials reported nausea, with a meaningful number needing anti-nausea medication or stopping treatment because of it

Iciek et al., 2009)

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These injections deliver B12 directly into the bloodstream via an intramuscular injection (shot)

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Beyond that, consistency over three to six months is what gives any approach a fair chance, and taking a monthly photo from the same angle is far more reliable than memory for noticing gradual change