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Starting low and adjusting based on results and tolerance is the recommended approach

Subcutaneous injection was chosen as 5A-1MQ specifically has poor oral bioavailability in mice, a phenomenon that does not occur in rats 26

Medications and alcohol : Long-term use of certain medications like proton pump inhibitors (PPIs) or metformin, and chronic alcohol use, can interfere with B12 absorption

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But, we need more studies to know how well it works and the best dose