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A 2025 European Journal of Clinical Nutrition commentary on the NICE guideline argued that the diagnostic threshold and clinical awareness still need to be tightened further, especially around pernicious anaemia, which is still under-recognised in primary care

Response depends on why you are using it

Refrigerate and use within 28 days

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The Croatian Phase I and II clinical trials for inflammatory bowel disease conducted in the 1990s by pharmaceutical company Pliva claimed safety with no significant toxicity, though complete peer-reviewed data never appeared in scientific literature beyond conference abstracts

Used as a reconstitution for certain chemicals