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In general, do not exceed 35 days of treatment, unless an estradiol rise indicates imminent follicular development

Patients with pernicious anaemia may therefore experience joint symptoms related to concurrent autoimmune conditions rather than the B12 deficiency itself

Putting the mechanism in perspective Taken together, the mechanistic literature paints a picture that is internally coherent: short peptides penetrate cells, can plausibly bind DNA in a sequence-selective way, and are associated with tissue-specific gene-expression changes

In terms of safety and tolerability, the adverse events were primarily mild to moderate gastrointestinal reactions, with no reports of severe hypoglycemia or death