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Cobalamin deficiency can lead to neurological manifestations such as progressive axonal demyelination, impaired peripheral and sensory nerve function, areflexia, loss of proprioception and vibration sensitivity, and subacute combined spinal cord degeneration (, )

A vial that should have been viable for weeks loses its protective edge far too soon simply due to improper storage

Longer uninterrupted dosing is not recommended because receptor sensitivity can diminish without cycling

Heightened alertness or mild anxiety: Occasionally reported when Semax is taken too late in the day

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