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For immunohistochemical staining, the tissue sections were inactivated by endogenous peroxidase with 3% hydrogen peroxide for 10 min and blocked with goat serum for 30 min

Diagnosis integrates clinical symptoms, B12 levels (or active B12/MMA/homocysteine where appropriate), antibody results, and exclusion of other causes

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Not all B12 forms are equal

Storage and handling impact on injection comfort Improperly stored compounded tirzepatide can develop particulates, pH changes, or degradation products that irritate injection sites