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24 25 Some patients may experience recurrence or worsening of symptoms when the interval between injections is extended or extended too quickly, and report that continuation of frequent intramuscular hydroxocobalamin injections, varying between twice weekly and once every three to four weeks, 65 is needed to remain asymptomatic

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Choline : Choline is an essential amino acid that is used throughout the body to build cell membranes, maintain healthy muscle and liver function, and produce acetylcholine, a neurotransmitter that regulates mood and is involved in forming memories and controlling muscle contractions