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Some autoimmune conditions may worsen with immune stimulation
Managing Side Effects Practical strategies that reduce GI symptoms during dose escalation: Eat smaller meals
In patients with painful DPN, clinicians should offer tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, gabapentinoids and/or sodium channel blockers to reduce pain (Level B) and consider factors other than efficacy (Level B)
Am Fam Physician 83 Langan RC, Goodbred AJ (2017) Vitamin B12 deficiency: recognition and management
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