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For patients receiving intramuscular B12 injectionsthe standard treatment for pernicious anaemia and severe deficiency neurological symptoms may start improving within one to two weeks , whilst haematological parameters typically normalise within approximately eight weeks

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MTX is typically administered in conjunction with folic acid to decrease the risk of toxicity which can manifest as hematologic, hepatic, pulmonary, infectious, and mucocutaneous adverse effects [4, 5]

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