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However, for individuals actively managing complex, reactive chronic illnesses like Long COVID, ME/CFS, or severe dysautonomia, such high starting doses are rarely recommended due to the high potential for gastrointestinal upset or rapid, uncomfortable detoxification reactions (often referred to as a Herxheimer reaction)

Vitamin B12 injections are often preferred for individuals with absorption issues or severe deficiencies since they bypass the digestive system and offer rapid delivery

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