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Sexual Medicine Reviews, 6(1), 45-53
Physical examination may reveal pallor, glossitis, neurological signs such as reduced vibration sense or proprioception, and in advanced cases, ataxia or cognitive impairment
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In many other areas, oral substitution at a sufficiently high dosage has already proven to be equivalent to injections and an improvement of neurological symptoms seems to be equally possible through oral administration (45, 46)
For vegetarians and vegans, it may be necessary to take supplements or eat fortified foods
