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avoid anticoagulants
Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society
combined use is speculative and may compound adverse metabolic and gastrointestinal effects with no safety framework to guide dosing

METHODS: PubMed was searched using the terms "methylcobalamin pain", "hydroxycobalamin pain", "cyanocobalamin pain", and "vitamin B12 pain." Animal studies that identified mechanisms of action for the effects of pain were collected