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Decide whether to continue, adjust, or complete the protocol

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Several coexisting conditions may falsely lower serum B 12 levels, including oral contraceptive use, multiple myeloma, pregnancy, and folate deficiency

Clinical guidelines recommend standard protocols of 100 mcg IM/SC once daily for 6-7 days, then every other day for 7 doses, then every 3-4 days for 2-3 weeks, then monthly, but these protocols dont even mention that injection site makes a huge difference in how well those doses actually work