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The combination may amplify gastrointestinal discomfort in susceptible individuals, though this represents an additive effect rather than a true pharmacological interaction

Maintenance Phase: Once adequate B12 levels are achieved, the frequency of injections can be reduced

When to Reassess If injection-site reactions worsen instead of improving over the first week, if fatigue persists past the loading phase, or if any unusual symptom appears, pause the protocol and consult a qualified clinician

Adding multiple additional compounds creates complexity that makes it impossible to identify what is working (or causing problems)