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While the term blown vein sounds scary, keep in mind that a vein rupture is generally harmless

It is metabolized from tryptophan into its active forms, nicotinamide adenine dinucleotide (NAD) and nicotinamide adenine dinucleotide phosphate (NADP) (, , )

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reactions persisting beyond 48 hours or involving induration suggest sensitivity to the bacteriostatic water preservative (benzyl alcohol) rather than the peptide itself

The NHS treatment pathway and the 2024 NICE guideline both assume B12 injections are given in a clinical setting against a confirmed deficiency, not self-sourced and self-administered

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