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The Route of Administration The most significant barrier is that hydroxocobalamin is licensed for parenteral administrationmeaning it must be given by injection (Intramuscular, IM)

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reassess after several weeks using objective logs and patient-reported feedback

Findings suggest it may operate differently than growth hormone, particularly in relation to receptor interaction and lean body mass

For randomised clinical trials, the Jadad scale (Jadad et al., 1996), as used to assign a quality score ranging from 0 to 5, based on randomisation, blinding, and withdrawal reporting