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Using oral cromolyn may be challenging in practice given its sometimes limited availability in pharmacies, difficulties in obtaining drug coverage in many parts of Canada as well as patient adherence to a drug that requires preparation and that is taken 4 times a day

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When B12 levels become problematic: High-dose supplementation (particularly doses exceeding 1,000 micrograms daily) Frequent B12 injections without medical supervision Underlying conditions affecting B12 metabolism Concurrent use of multiple B12-containing supplements The NHS does not set an upper safe limit for vitamin B12 because harmful effects from excessive intake have not been definitively established