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Some historical or research protocols have used much higher doses (e.g., 250 mg/kg as a single IV bolus in diagnostic growth-hormone testing), but such regimens are uncommon outside controlled studies.Dose escalation should proceed cautiously, with monitoring of vital signs, electrolytes, and-if relevant-ammonia levels
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Having everything laid out and ready to go minimizes the time your vials are open and reduces the chances of a mistake

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However, a 2020 report highlights that further research is necessary to understand the potential role of vitamin B12 in the development of diabetes