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We will return to Chivay to enjoy lunch before beginning our journey to Puno, the folklore capital of Peru

In some countries hydroxocobalamin has completely replaced cyanocobalamin as first choice for vitamin B 12 therapy because it is retained in the body longer and can be administered at intervals of up to three months

After this "reset," restarting the peptide often produces a second wave of effectiveness often better than the first

If symptoms progress, seek medical care

In UK practice, monitoring is primarily based on clinical response rather than routine blood tests, as post-treatment serum B12 measurements can be misleadingly high and may not reflect tissue levels

Hydroxocobalamin injection is primarily used to treat or prevent vitamin B deficiency in patients