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Cycles last 8 to 12 weeks followed by 4 to 8 weeks off

In pernicious anaemia, there is a very high risk of worsening or recurrence of symptoms when B12 injections are stopped, and even when people are forced to switch to oral supplementation

The combination of altered eating patterns, potential fluid loss, and metabolic adjustments may create conditions conducive to headache development

The connection lies in B12s role in neurotransmitter synthesis, particularly serotonin, which influences mood regulation

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