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If neurological symptoms worsen or fail to improve after four to six weeks of appropriate treatment , further investigation is necessary to exclude alternative diagnoses or complications

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For others, it might take a few weeks of consistent injections before you notice a change if your symptoms are more complicated, such as numbness, exhaustion, or memory problems

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WARNINGS: Patients with early Leber's disease (hereditary optic nerve atrophy) who were treated with cyanocobalamin suffered severe and swift optic atrophy