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[1] [3] The standard UK treatment involves hydroxocobalamin 1mg intramuscular injections, with dosing regimens typically consisting of initial loading doses (e.g., every other day for two weeks) followed by maintenance doses every 2-3 months for conditions like pernicious anaemia

PMID: 19931318.

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It can stay in its active form for 48 hours

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if it doesnt, the problem may be related to estrogen levels