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Patients with megaloblastic anemia may experience hypokalaemia and sudden death if they are given intensive treatment with cyanocobalamin (vitamin B12)
Because of this, I recommend any patient who is symptomatic and has suboptimal levels of vitamin B12 (as defined above) consider a trial of sublingual B12
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In addition to boosting hydration power, it will make the spacer drink taste better if youre not a fan of plain old H2O
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