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Food & Drug Administration (FDA) advised patients to be cautious of the use of NSAIDs and advocated for use of an alternative such as ibuprofen/paracetamol ( TNF Antagonists Antibodies against TNF have been used for years as treatment for autoimmune diseases such as rheumatoid arthritis and inflammatory bowel disease

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Recently, a double blinded randomised controlled trial was published in which participants were administered either methyl-cobalamin or placebo for 6 weeks and then their treatment switched without washout for a further 6 weeks [64]

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