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Proponents argue that the current Biden-era restrictions on compounding of the substances due to safety concerns and a lack of data have fueled a gray market of overseas suppliers, raising safety concerns as Americans inject themselves with unvetted substances

Some individuals may struggle to absorb enough B12 from their diet, especially those with conditions like pernicious anemia, certain gastrointestinal disorders, or those taking medications that impact absorption

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If withdrawal symptoms arise, it may be necessary to pause the taper for a period of time or raise the dose of the opioid analgesic to the previous dose, and then proceed with a slower taper