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The picture is consistent: the adverse events are overwhelmingly gastrointestinal, they track with dose, and they cluster during escalation

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According to the Mayo Clinic, parenteral vitamin B12 therapy is clinically indicated for treating deficiency caused by pernicious anemia, gastrointestinal disorders such as tropical sprue, and conditions resulting in malabsorption like pancreatic insufficiency

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The difference between a 98% pure peptide and an 85% pure one might seem minor, but that 13% impurity can include problematic compounds