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Excess B 12 beyond the blood's binding capacity is typically excreted in urine

An increase of 6.5 fold and ~2 fold in brain delivery of methylprednisolone [43] and the opioid peptide [44] respectively were reported in rat brain when compared with a control where a free drug was used

[6] [7] For patients with neurological symptoms, hydroxocobalamin 1mg IM is given on alternate days until no further improvement, followed by maintenance injections of 1mg every two to three months

Hence the evidence is not adequate to make clinical recommendations

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