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33,34,35,36,37 One study suggests that length of time from diagnosis of cognitive impairment is important for response rate, in that patients who had experienced symptoms for less than 12 months improved on B12, whilst those with symptoms for more than 12 months continued to decline

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[1] However, whilst acute toxicity is rare, elevated serum B12 levels can occasionally occur and may warrant investigation, particularly when they arise unexpectedly or in the context of certain medical conditions