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Although rare, adverse effects of high-dose vitamin B12 have been reported, including allergic reactions such as fever, rash, itching, hot flushes, dizziness, and nausea, across all cobalamin forms and administration routes ( Intramuscular (IM) injection is the most invasive and costly administration method, requiring trained personnel and clinical visits

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A 2023 study from the University of Arizona noted that nearly 40% of rodent subjects exhibited conditioned taste aversion after just two oral administrations of unmasked dihexa, requiring protocol modification to maintain experimental integrity

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