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Follow-up testing: Keep checking B12 levels and adjust treatment as needed, every 3-6 months

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261 In an uncontrolled trial in 47 subjects with fibromyalgia, 400 mg of oral SAMe twice daily plus 200 mg of intramuscularly injected SAMe once daily for six weeks decreased tenderness, increased general well-being, and improved scores measuring depression, anxiety, and mood

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The combination between DPI and vincristine was also synergistic but less potent