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Therapeutic response to cyanocobalamin may decrease due to elderly age, infection, renal insufficiency, diabetes mellitus, marrow suppressants use (e.g
Prolonged use of Vitamin B6 (over 2 months) at high doses exceeding 1g/day can lead to severe peripheral neuropathy, with symptoms including unsteady gait and numbness in the hands and feet
The strongest effects of stress are seen in those with pre-existing cardiovascular disease
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