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Keep a symptom journal to note improvements in energy, mood, sleep, or focus

Contraindications include known hypersensitivity to any component of the injection (including cobalt hypersensitivity), a history of severe reactions to thiamine/pyridoxine/cobalamin injections, and Lebers hereditary optic neuropathy (for B12-containing products)

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[30] This property allows the convenient preparation of cobalamin analogs with different substituents, via nucleophilic attack on alkyl halides and vinyl halides