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Options for managing tolerance include a brief dose reduction for 4 to 8 weeks ("drug holiday" at a lower dose, not complete cessation), lifestyle optimization to maximize the medication effect, evaluation for other contributing factors (thyroid function, cortisol, sleep quality, medication interactions), and consideration of adding a complementary compound to address specific aspects of the plateau
However, during the 12-month therapy, the patient developed a rash at the site of the cyanocobalamin injection [85]
Downtime and recovery: Theres no real downtime
