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Seek urgent same-day assessment or call 999 for emergency care if experiencing: Severe chest pain Severe shortness of breath Fainting or collapse Acute or rapidly worsening neurological deficits (such as new limb weakness, sudden gait disturbance, or bladder/bowel dysfunction) Persistent or worsening anaemia symptoms despite treatmentincluding breathlessness, chest discomfort, palpitations, or extreme fatigueshould trigger medical review

Total doses per vial: How many complete doses the vial provides at your specified dose level

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and patients with pernicious anemia who have optic neuropathy COBALAMIN (Vitamin B12) Deficiency Causes Vegetarians (dietary deficiency) Older adults: atrophic gastritis affects 10% 30% and leads to decrease in hydrochloric acid secretion in the stomach and decreased absorption of Vitamin B12 The liver can store up to six years worth of Vitamin B12 so deficiencies are rare Effects of deficiency Megaloblastic anaemia (pernicious anaemia) Progressive demyelination of nerve cells Elevation in levels of circulating homocysteine that leads to production of defective collagen and elastin with a negative impact on arteries, bone and skin Deep vein thrombosis is associated with homocysteinemia that causes the activation of the intrinsic coagulation cascade Symptoms include fatigue, weakness, constipation, loss of appetite and weight loss Numbness, tingling of the feet imbalance, depression, confusion, dementia, poor memory and glossitis

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Peptide Vials (NAD+, 1000 mg each): 8 weeks 6 vials (total 5,075 mg used) 12 weeks 8 vials (total 7,875 mg used) 16 weeks 11 vials (total 10,675 mg used) Insulin Syringes (U100, 1 mL): Per week: 7 syringes (1/day) 8 weeks: 56 syringes 12 weeks: 84 syringes 16 weeks: 112 syringes Bacteriostatic Water (10 mL bottles): Use 3.0 mL per vial for reconstitution