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Vitamin D toxicity is uncommon but can occur when very large doses are taken consistently over time

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doi:10.7860/JCDR/2016/18208.8127 If a good first response is seen, a second injection may be considered when the improvement from the first injection begins to taper off

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Intrinsic factor, a protein that shuttles B12 through the absorption process, becomes saturated after a meal containing an above-average amount of B12 and about 4 to 6 hours are required before it can efficiently absorb another dose (IOM, 1998)