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It thus may not be misbranded, misused, or mislabeled as a drug

A provider-supervised taper or switch to oral B12 supplementation is a reasonable alternative if MIC B12 proves unsuitable

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10.1097/MOG.0b013e32833dccde 32
The choice between PO and IM vitamin B 12 seems ideal for shared decision making

However, surgery should be considered a last resort after all other failed treatments