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The symptoms are challenging to control as the response to pharmacological monotherapy is frequently suboptimal, and combination treatments are often necessary for adequate pain control [10]

In an online survey, almost one third of 683 participants reported cancellation of B 12 injections during the covid-19 lockdowns, with subsequent worsening of symptoms and often with negative emotions and feelings including anger, fear, disappointment, feeling let down, and feeling undervalued

In these cases, high B12 is not causing the liver damage