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High doses of B12 were successful in bringing the subjects sleep-wake cycles back into a normal range

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There is no need to chill or warm the diluent beforehand

Patients frequently experience: Fatigue and generalised weakness that persists despite adequate rest Breathlessness on exertion due to anaemia Palpitations and reduced exercise tolerance Pallor of the skin and mucous membranes These symptoms result from megaloblastic anaemia, where impaired DNA synthesis leads to the production of abnormally large, dysfunctional red blood cells with reduced oxygen-carrying capacity