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the label also warns that rash, hives, or swelling of the face, mouth, lips, or tongue can signal a hypersensitivity reaction requiring emergency care, though no generalized allergic reactions were documented in the original trials Because current supply comes only from compounded preparations rather than an FDA-verified finished product, potency, purity, and sterility can vary by pharmacy, and unregulated online sources carry added contamination or mislabeling risk

Pernicious anemia develops when your body cannot make enough healthy red blood cells because it doesnt have enough vitamin B12