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The different dosing paradigms (short intensive courses vs

It works on a different pathway than either medication, which is why it stacks well with both

It warns that allergic or other life-threatening reactions can occur even if the shot is administered correctly

Injection-site reactions

Treat sleep hygiene by getting 7 to 9 hours on a regular schedule and employ stress-reduction tools like mindfulness and cognitive behavioral strategies to reduce cortisol-associated oxidative stress

There are no other absolute contraindications reported for hydroxocobalamin use in deficiency states, but caution is advised in individuals with conditions such as early Lebers optic neuropathy (a rare hereditary optic atrophy) due to the theoretical risk of worsening vision