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There are several mechanisms proposed in attempt to explain copper irritancy

Initially, a person may need B12 supplementation shots every other day for around 2 weeks or until symptoms improve

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Over-dosing or skipping titration steps can cause severe nausea, dehydration, gastroparesis (delayed stomach emptying), and in rare cases pancreatitis or hypoglycemic events

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[1] Because the ingredients are compounded rather than supplied as an FDA-approved fixed-dose product