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Payers want to see that the prescriber is following the FDA-approved escalation protocol: starting at 2.5mg weekly for 4 weeks, then increasing to 5mg weekly, with subsequent increases as clinically indicated

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It has not yet received FDA approval, so it is classified as a research compound

Since the body cannot synthesize Vit B9, it must be supplemented exogenously and gastrointestinal dysfunction, a prominent dysautonomic feature of MSA, may explain such deficiency

Clinically, B12 shots have long been used to treat cyanide poisoning