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No adverse fetal effects have been documented from normal therapeutic doses of hydroxocobalamin in human pregnancies

Vitamin B12 deficiency can occur due to dietary restrictions (vegetarian or vegan diets), absorption issues (pernicious anemia or gut disorders like celiac disease or Crohns disease), age-related changes in elderly patients, or long-term use of certain medicines

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In these situations, vitamin B12 is the priority treatment, as untreated deficiency can lead to irreversible neurological complications

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This price difference reflects more complex manufacturing and lower stability requiring careful handling