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Nevertheless, several difficulties are encountered in the implementation of these treatment methods, such as the requirements of technical expertise in purifying small molecules, the dosage of small purified molecules to treatment, whether the harmful genes among the opportunistic pathogenic bacteria can be completely knocked out, and whether knocking out these bacterial genes have potential risks implications to the host health

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According to the NHS, the usual pattern depends on the cause: Non-dietary cause (for example an absorption problem): an injection of hydroxocobalamin every two to three months, usually for life

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