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Stopping biologic therapy or immunosuppressants without medical guidance can trigger a flare
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B12 is poorly absorbed in these conditions, like other nutrients, but its deficiency from poor absorption also contributes to further negative changes in intestinal health

[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes

Then, place a warm compress over the injection site
