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GSH cannot be administered directly because two pharmaceutical problems have been observed: poor bioavailability with oral administration, and a short half-life (2 min) with intravenous administration [54]

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Monitoring recommendations: Baseline investigations: Full blood count, B12 level, folate, and intrinsic factor antibodies (if pernicious anaemia suspected) During initial treatment: Potassium monitoring in severe deficiency (risk of hypokalaemia) Follow-up: Repeat full blood count after 8 weeks to confirm haematological response Long-term: Annual review to ensure compliance with maintenance injections