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Fourth, exclusion of alternative causes such as dietary insufficiency, gastric surgery, or small bowel pathology

There are no other absolute contraindications reported for hydroxocobalamin use in deficiency states, but caution is advised in individuals with conditions such as early Lebers optic neuropathy (a rare hereditary optic atrophy) due to the theoretical risk of worsening vision

Easier to Measure (Larger, clearer syringe units) Smaller Injection (Less fluid, higher concentration) References Wang W