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The methylcobalamin component is generally safe in renal impairment, though accumulation of cobalt has been reported in patients with severe renal dysfunction receiving high doses of vitamin B12

Its not an FDA-approved drug, and buying it outside the regulated supply chain means you have no idea whats really in it

It is the new dose plus whatever remains from your previous doses

If you're on any medication where absorption timing matters, flag this at intake

A doctor (usually a dermatologist) may biopsy your skin, and they may have to start systemic medications that suppress your immune system

Dosing protocol design also influences tolerability outcomes