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Fatigue accompanied by anhedonia, sleep disturbances, or changes in appetite beyond those expected from the medication warrants evaluation for depression, potentially using validated screening tools like the PHQ-9

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Optimal injection timing: First thing in the morning, at least 12 hours after your last meal, and 30-45 minutes before eating breakfast

These nerve-related changes can occur even without anemia being present, which means standard blood counts alone may not catch a developing deficiency