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This means integrating targeted nutritional support alongside essential lifestyle modifications, such as aggressive pacing to avoid post-exertional malaise, meticulous symptom tracking, and nervous system regulation techniques

There are no other absolute contraindications reported for hydroxocobalamin use in deficiency states, but caution is advised in individuals with conditions such as early Lebers optic neuropathy (a rare hereditary optic atrophy) due to the theoretical risk of worsening vision

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