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Mecobalamin improved pernicious anemia in an elderly individual with Hashimotos disease and diabetes mellitus Of course, were not suggesting you treat PA with oral tablets

The powder should dissolve gradually

If still very symptomatic then B12 injection can be given with clear understanding that the interaction with healthcare increases transmission risk of COVID19

[16] [2] For patients with neurological involvement, hydroxocobalamin 1mg intramuscularly on alternate days until no further improvement is seen, followed by maintenance injections every 2 months

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