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For diarrhea, stay hydrated to replace lost fluids, avoid foods that worsen loose stools, and let your provider know if it persists beyond the first few weeks at a new dose

Cobalamin Deficiency in the Elderly

So can John have it
They may need to adjust your dosage or provide strategies to manage your symptoms

A rise in creatinine level up to 30% from baseline is an anticipated finding with drug initiation or dose modification and is due to the reduction in intraglomerular pressure
