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Patients should specifically inform their doctor if they have a history of the following conditions : thyroid disorders or thyroid nodules, pancreatitis or elevated pancreatic enzymes, kidney disease, liver disease, diabetic retinopathy, depression or suicidal ideation, gastroparesis or severe gastrointestinal disorders, or gallbladder disease

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The methylcobalamin component begins working immediately to support B12 levels, though the impact on energy and well-being may take 2 to 4 weeks to become noticeable, depending on your baseline B12 status