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In addition, pathways involving the cerebrospinal fluid (CSF), vasculature, and lymphatic system have been implicated in transporting molecules from the nasal cavity to the CNS [8]

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Titration: There is generally no need for upward titration with B-complex vitamins as one might do with certain drugs, but if a patient is frail or known to react to injections, the provider may choose to start at a lower dose (for example 0.25-0.5 mL) and then increase to 1 mL as tolerated