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The route of administration is a critical factor

A medication called hydroxyurea (Hydrea, Droxia, Siklos), a cancer drug, is also used to treat some patients with sickle cell anemia

Effects on frontal or vertex follicles (where hair loss actually occurs) may differ, though subsequent studies have confirmed activity in these regions

Hydroxocobalamin injections are the UK first-line treatment, administered intramuscularly to ensure reliable B12 delivery independent of gut absorption