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Peripheral neuropathy, subacute combined degeneration of the spinal cord, or cognitive impairment indicate more advanced deficiency and generally require intensive treatment over extended periods
However, full effect may not develop for four to eight weeks as the medication reaches steady-state concentration and the brains appetite circuits fully adapt
doi: 10.1186/s12891-015-0516-3 70 LeeAQiaoYGrigorievGChenJPark-MinKHParkSHet al
doi:10.1002/hep.21424
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