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renal insufficiency, hypertension, osteoporosis and myasthenia gravis

The classic symptoms of B12 deficiency are persistent fatigue, tingling or numbness in the hands and feet, problems with memory and concentration, mouth ulcers, a sore red tongue, and pale or yellow-tinged skin

a therapeutically effective amount is an amount sufficient to decrease, prevent or ameliorate the symptoms associated with a medical condition

They leverage the fact that it was in human trials to imply a level of proven efficacy and safety for that purpose, which is a gross misrepresentation of the facts