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Immune System : Vitamin B12 injections may impact the immune system, particularly in individuals with weakened immune systems

Thiamine deficiency is well documented in individuals with chronic alcohol use and malabsorption conditions

Neurological symptoms may take longer to resolveoften several weeks to monthsand improvement may be gradual rather than immediate

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Treatment with intranasal cyanocobalamin should be delayed until symptoms resolve in patients with nasal congestion, allergic rhinitis, and upper respiratory infection