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When to Reassess If injection-site reactions worsen instead of improving over the first week, if fatigue persists past the loading phase, or if any unusual symptom appears, pause the protocol and consult a qualified clinician

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1: Investigations of our patient MCV: Mean corpuscular volume, MCH: Mean corpuscular hemoglobin, WBC: White blood cell, TSH: Thyroid stimulating hormone, LDH: Lactate dehydrogenase, DCT: Direct Coombs test, ANA: Anti-nuclear antibody, IF: Intrinsic factor, NCS: Nerve conduction study, SACD: Subacute combined degeneration of the spinal cord Fig