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Treatment considerations include: Concurrent folate supplementation if deficient (never give folate alone, as it may precipitate neurological deterioration) Potassium monitoring during initial treatment in severe anaemia or at-risk patients (e.g., those with heart failure) Response assessment: reticulocyte count peaks at 57 days, haemoglobin normalises within 68 weeks Neurological symptoms may take 612 months to improve and may not fully resolve Patients should be advised that treatment for pernicious anaemia or post-surgical deficiency is lifelong
Individual physiology and the specific therapy play a significant role
However, sterile water is still preferred when the injection must be preservative-free
Research-grade peptides are not manufactured under Good Manufacturing Practice (GMP) standards applicable to licensed medicines, meaning purity and potency cannot be guaranteed
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