A small needle (same size as those used on the face) will be inserted into the appropriate area and Botox or the like will be injected at one or two sites
Some medications can reduce the ability to absorb vitamin b12, such as proton pump inhibitors, and PPIs
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That said, injectable forms may be more effective for systemic inflammation or complex cases involving both GI and musculoskeletal symptoms
This will keep the needle from bending as you insert it into the rubber stopper
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