How the Drug Works

Tests for occult blood screen for unseen blood cells in the stool itself or in the toilet water around the stool. Specially treated pads turn a different color in the presence of blood.

Occult blood in the stool (feces) may be an indication of a disease in the digestive or gastrointestinal tract such as hemorrhoids, diverticulitis, fissures, ulcers, polyps, colitis, or colorectal cancer (cancer in colon or rectal area).

Uses

To screen for early signs of digestive tract diseases, including ulcers, colitis, polyps, fissures, diverticulitis, hemorrhoids, and colorectal cancer.

Recommended for people older than 40 years of age and for those who have a personal or family history of lower intestinal disorders or colorectal cancers.

These tests do not replace regular physical and rectal examinations by your doctor. However, they may show the need for further examinations.

Diet: Eat a normal, well-balanced diet for 2 days before and throughout the testing period (eg, well-cooked poultry, raw beef, lamb), tuna fish, peanuts, high fiber foods such as bran cereal and popcorn, and plenty of raw or cooked lettuce, spinach, corn, prunes, grapes, plums, and apples.). Such a diet reduces the number of false positive results and at the same time the roughage helps to uncover “silent” lesions which may bleed only intermittently. Do not eat red or rare meat, horseradish, turnips, radishes, broccoli, cauliflower, cantaloupe, melons, or large amounts of citrus fruits. Consult your doctor before altering or discontinuing a special diet.

Do not use until 3 days after menstrual bleeding has ceased, or while you have bleeding hemorrhoids or constipation. Do not use any rectal ointments, suppositories, or certain medications for 2 days prior to or during the test period. Contact your doctor before stopping any drug therapy.

Kits containing a positive control package: Avoid contact with eyes, skin, clothing, heat, or open flame. In case of an accidental spill or direct contact, wash the affected area with large amounts of water. If ingested, administer large amounts of water. Do not induce vomiting. Call the poison control center. Toilet cleaners, disinfectants, and deodorizers in the toilet bowl and tank can interfere with test results. Remove these items and flush repeatedly until water is clear.

Perform the test on 3 consecutive bowel movements. If the sequence is broken, continue the test until 3 bowel movements have been tested. Some digestive tract bleeding occurs intermittently. Checking 3 consecutive bowel movements will offer a better chance of finding lower intestinal bleeding.

Quality control tests or tests for toilet water quality may be required. Read individual test directions carefully. Specimen collection and preparation of slides, collection papers, and filter papers returned to doctor’s office:

1. Provide all information requested on outside of packet: Name, address, date, doctor, etc.
2. Collect sample from the toilet bowl.
3. Using the applicator provided, apply a thin smear to the slide or paper.
4. Close the cover. Place slide away from heat and light. 5. Mail or deliver to doctor’s office.

Specimen collection and preparation of f1ushable tissue and pads: Carefully drop tissue or pad into toilet bowl. Wait the required length of time, then read the results as directed.

Drug Interactions

Tell your doctor or pharmacist if you are taking or planning to take any over­the-counter or prescription medications or dietary supplements while testing for occult blood. The following drugs and drug classes may interact with the test, leading to questionable results.

1. Anticoagulants (eg, warfarin)
2. Cancer chemotherapeutic drugs
3. Antimetabolites (eg, methocorticosteroids sone)
4. Aspirin dipyridamole (8g. Persantine)

Guidelines for Use

• Read the product instructions carefully prior to testing. Follow the directions on the package label exactly.
• A positive test indicates the presence of blood but does not necessarily mean that a serious condition exists. Discuss all positive test results with your doctor.
• False negative results (a false reading even though blood is actually present) can be caused by an improper sampling technique, ingestion of more than 250 mg a day of vitamin C (ascorbic acid), large amounts of citrus fruits, use of expired reagents or kits that have been improperly stored, or lesions not bleeding at the time of the test.
• False positive results (a positive reading even though no blood is actually present) can be caused by drugs causing gastrointestinal bleeding, red or rare meat, foods such as horseradish, turnips, broccoli, cauliflower, or melons (eg, cantaloupe), toilet bowl cleaners, and sources of nongastrointestinal bleeding such as nose bleeds, menstruation, and hematuria (blood in the urine).
• The best results are achieved when 3 consecutive stool specimens are tested.
• Follow special diet for 2 days prior to testing. Do not change diet or prescription medications without first discussing it with your doctor.
• Have all the materials you need on hand before beginning the test: Testing package, pencil or pen, timer (stopwatch or watch with a second hand), and a clean, dry container.
• For some tests, color vision may be needed to properly read the test results. Have someone else confirm results if in doubt.
• Hema Chek slide test Use a clean container or toilet paper to collect sample. Do not collect from the toilet bowl.
• Store slide tests at room temperature in a dry place. Protect from heat and light. Keep bottle tightly closed.
• Pad and tissue tests -Remove all toilet cleaners and disinfectants from the toilet bowl and tank. Flush several times.
• Flush the toilet after urinating. Then have bowel movement. Do not throw toilet paper in toilet following bowel movement.
• Protect from heat, sunlight, or fluorescent light. Store at room temperature (59° to 86°F). Do not store in the bathroom or in an area where there is a high humidity or moisture level. Do not store in the refrigerator or in an area where the temperature will exceed 86°F. Keep out of the reach of children. Do not use after expiration date on pouch.

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Opiates are the highly used drugs to treat any kind of pain. These are the drugs maximally sold across the counter. But people come to the terms after a while that these opiates are doing more harm than good and then they want to get rid of the habit. But many times, the habit has crossed to the level of opiate addiction and definitive treatment is required to detoxify the system of opiates.

Suboxone treatment by Meditox is known to cure the person of his opiate addiction totally. The revolutionary drug Buprenorphine works as opiates but in a pseudo-analgesic way. It fools the brain as if opiates are present. But it does not create any dependency. So, suboxone detox in the form of buprenorphine and naloxone is the best tool for millions of opiate addicts worldwide.

Also this kind of suboxone detox is possible on an out-patient basis and no need is there to get admitted, as opposite to methadone that was previously used for the detoxification process. So, the patient can take suboxone from the comfort of their homes without any hassles. After the body gets de-addicted, patient can gradually lower the dosage of suboxone and stop it after a certain period. Handling an opiate addiction was never so easy!

Blood clot dissolvers

How the Drug Works:

Thrombolytic agents dissolve blood clots and restore blood circulation to affected body tissue.

Uses:

To dissolve blood clots, including those blocking coronary arteries in acute heart attacks.

Precautions:

Alteplase: To help manage acute ischemic strokes in adults to reduce the chances of disability, or to reduce the incidence of congestive heart failure (CHF) and death due to heart attack.

Streptokinase: To dissolve large blood clots in legs.

Unlabeled Uses: Occasionally doctors may prescribe alteplase for the treatment of unstable angina pectoris (chest pain).

Abnormal heartbeats: Use of thrombolytic agents to dissolve clots in coronary arteries (acute heart attack) may result in abnormal heartbeat. Heart rate will need to be monitored during and following therapy.

Pregnancy: Safety for use during pregnancy has not been established.

Use only if clearly needed and the potential benefits to the mother out­weigh the possible hazards to the fetus.

Breastfeeding: It is not known if thrombolytic agents appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness have not been established.

Lab Tests: Lab tests will be required to monitor therapy. Tests may include platelet counts, thrombin time (TT), activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen levels, hematocrit counts, as well as the monitoring of blood pressure, heart rate and rhythm, and other vital signs (eg, respirations, temperature).

Drug Interactions:

Tell your doctor or pharmacist if you are taking or will be taking any over­the-counter or prescription medications or dietary supplements while taking a thrombolytic agent. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with thrombolytic agents:

• Anticoagulants (eg, warfarin)
• Aspirin antiplatelet agents heparin (eg, Hep-Lock)
• Ndomethacin (eg, Indocin)

Side Effects:

Every drug is capable of producing side effects. Many thrombolytic agent users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Bleeding: Bleeding at puncture and incision sites; bleeding from rectum, stomach, lungs, gums, mouth, nose, or urinary tract.

Digestive Tract: Nausea; vomiting.

Circulatory System: Internal bleeding; irregular heartbeat; changes in blood pressure.

Skin: Rash; unusual bruising.

Other: Fever; chills; difficult or fast breathing; back pain.

Guidelines for Use:

• This medicine will be prepared and administered intravenously (into a vein) by your health care provider in a medical setting.
• Dosage is individualized.
• Effectiveness depends on how quickly the drug is given.
• Bleeding is a common side effect of thrombolytic agent therapy.
• Notify your doctor immediately if you experience fever, shivering, chills, rash, hives, swelling, or difficult or rapid breathing.

Dipyridamole Information - Drug Interactions

Type of Drug:

Antiplatelet agent.

How the Dipyridamole Products Works:

Platelets are components of the blood that aid in clot formation. Blood clots often form on platelets that have clumped together. Dipyridamole helps prevent blood clots from forming by preventing platelets from clumping together.

Uses of dipyridamole Products :

Given in combination with oral anticoagulants (eg, warfarin) to prevent blood clot formation after heart valve surgery.

Unlabeled Uses: Occasionally doctors may prescribe derivable with aspirin to prevent heart attacks and reduce heart attack damage.

Precautions:

Do not use in the following situations: Allergy to the drug or any of its ingredients.

Use with caution in the following situations: coronary artery disease, severe liver disease low blood pressure

Hypo tension (low blood pressure): Dipyridamole may aggravate light-headedness in people with low blood pressure. Use caution when rising from a sitting or lying position.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out­weigh the possible risks to the fetus.

Breastfeeding: Dipyridamole appears in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness have not been established in children younger than 12 years of age.

Lab tests may be required to monitor therapy. Tests include liver function monitoring.

Side Effects of Pipyridamole

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Stomach ache; diarrhea; vomiting.

Other: Dizziness; light-headedness; fainting; headache; rash; flushing; itching; abnormal liver tests.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• Take without regard to food, but take with food is stomach upset occurs.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• If using this medicine in combination with oral anticoagulants (eg, warfarin), do not take aspirin, unless instructed by your doctor.
• Lab tests may be required to monitor therapy. Be sure to keep appointments.
• Store at room temperature (59° to 86°F).

Anagrelide - Guidelines for Using Anagrelide - Uses and Benefits

Type of Drug:

Antiplatelet agent.

How the Drug Works:

It is not known exactly how anagrelide reduces blood platelet levels. It is thought that it may slow down how fast platelets are produced and released by the bone marrow

Uses:

For the treatment of patients with essential thom body to the mia (too many blood platelets) to reduce the elevated platelet count and the risk of clothing and associated symptoms.

Precautions:

Do not use in the following situations: Allergy to the drug or any of its ingredients.

Use with caution in the following situations: heart disease, known or suspected kidney disease liver disease

• Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out­weigh the possible risks to the fetus.

• Breastfeeding: It is not known if this drug is excreted in breast milk. Consult your doctor before you being breastfeeding.

• Children: Safety and effectiveness in patients younger than 16 years of age have not been established.

• Lab Tests: Lab tests will be required to monitor therapy. Tests include cardiovascular exams, blood counts, and kidney and liver function monitoring.

Drug Interactions:

Tell Your doctor or pharmacist if you are taking or planning to take any over the counter or prescription medications or dietary supplements while taking this drug. Drug doses may need to be modified or a different drug prescribed. Sucralfate (Carafate) may interact with anagrelide.

Side Effects:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Circulatory System: Fast heartbeat; pounding in the chest (palpitations); heart failure; chest pain.

• Digestive Tract: Diarrhea; stomach pain; nausea; gas; vomiting; indigestion; appetite loss.

• Other : Headache; weakness; swelling; pain; dizziness; difficulty breathing; rash; hives; abnormal skin sensations; back pain; general body discomfort.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• Dosage will usually be slowly increased to achieve maximum benefit.
• Take without regard to meals. Take with food if stomach upset occurs.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.
• Women of childbearing potential must use adequate contraception while· taking this drug. It may cause fetal harm when administered to a pregnant woman.
• Lab tests will be required to monitor therapy. Be sure to keep appointments.
• Store at controlled room temperature (59° to 71° F) in a light-resistant container.

Dipyridamole-aspirin Guidelines for Using Dipyridamole-aspirin - Uses and Benefits

Type of Drug:

Combination anti platelet agent.

How the Dipyridamole-aspirin Works:

Aspirin and dipyridamole work together to prevent blood clots from forming by preventing platelets from clumping together. Platelets are parts of the blood that aid in clot formation.

Uses of Dipyridamole/aspirin:

To reduce the risk of stroke in patients who have had transient ischemia of the brain (TIAs) or complete ischemic stroke because of blood clots.

Precautions:

Do not use in the following situations: allergy to dipyridamole, aspirin, NSAIDs, or any of their ingredients asthma, nasal polyps, and rhinitis syndrome viral infections with or without fever, in children or teenagers

Use with caution in the following situations: alcohol use kidney disease bleeding abnormalities liver disease coronary artery disease low blood pressure gastrointestinal bleeding or peptic ulcer disease ulcers

• Reye syndrome: There is a risk of Reye syndrome in children and teenagers when using aspirin in certain viral illnesses. Do not use in children or teenagers with viral infections with or without fever.

• Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only when clearly needed and potential benefits out­weigh the possible risks to the fetus. Avoid the combination in the third trimester of pregnancy because of the aspirin component.

• Breastfeeding: Dipyridamole and aspirin are excreted in breast milk.

Consult your doctor before you begin breastfeeding.

• Children: Safety and effectiveness have not been established. This product is not recommended in children and teenagers because of the aspirin component.

• Lab Test: lab tests may be required during treatment. Tests include liver and kidney function, blood counts, urine tests, and bleeding tests.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over- the-counter or prescription medications or dietary supplements with this drug. Drug doses may need to be modified or a different drug pre­scribed. The following drugs and drug classes interact with this drug:

• ACE inhibitors (eg, captopril)
• Adenosine (Adenocard)
• Anticoagulants (eg ibuprofen)
• Ethotrexate (eg, Rheumatrex)
• Diuretics (eg, furosemide)

Side Effects of Dipyridamole-aspirin:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

• Nervous System: Headache; forgetfulness; convulsions; confusion; drowsiness; dizziness; fainting; weakness.

• Digestive Tract: Stomach pain; indigestion; heartburn; nausea; vomiting; diarrhea; coffee-ground or bloody vomit; appetite loss; dark or bloody stools; rectal bleeding; stomach bleeding; hemorrhoids.

• Other: Unusual bleeding or bruising; nosebleed; anemia; joint, chest, muscle, or back pain; arthritis; rash; itching; hives; general body discomfort; coughing; upper respiratory tract infection; accidental injury; heart failure; abnormal tissue growth; fatigue.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.
• Do not stop taking or change the dose, unless instructed by your doctor.
• Swallow capsules whole. Do not crush or chew.
• Take with food if stomach upset occurs.
• Do not interchange with individual components of aspirin and dipyridamole.
• If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, consult your doctor or pharmacist.
• Patients who consume 3 or more alcoholic drinks every day are at a higher risk of gastrointestinal bleeding while taking aspirin.
• Do not use in children or teenagers with viral infections with or without fever because of the risk of Reye syndrome associated with use of aspirin in certain viral illnesses.
• Do not use other aspirin-containing products, unless instructed by your doctor.
• Notify your doctor if you are pregnant, become pregnant, plan to become pregnant, or are breastfeeding.
• Contact your doctor immediately if you experience signs and symptoms of unusual bleeding, gastrointestinal bleeding (eg, bloody vomit, dark tarry stools), or recurrent signs of stroke or TIA.
• Notify your doctor if you experience bothersome side effects such as headache, indigestion, stomach pain, nausea, dizziness, or excessive bruising.
• Do not take aspirin if you have a known allergy to NSAIDs, asthma, rhinitis, or nasal polyps.
• Lab tests may be required to monitor treatment. Be sure to keep appointments.
• Store at room temperature (59 to 86°F) in a dry pl ace.

Folic Acid Information - Drug Interactions, Uses and Benefits

Type of Drug:

Folate; folacin; pteroylglutamic acid.

How the Drug Works:

Folic acid stimulates the production of red and white blood cells and platelets (used in clotting). Folic acid acts on megalomaniac bone marrow to produce a normoblastic marrow.

Uses:

To treat anemia (low red blood cell count) caused by folic acid deficiency due to digestive disorders (eg, spruce), poor diet, pregnancy, infancy, or childhood. Folic acid is rarely taken alone.

Precautions:

Do not use in the following situations: Allergy to folic acid or any of its ingredients.

Use with caution in the following situations: alcoholism anemia due to vitamin B 12 deficiency epilepsy controlled with phenytoin, primidone, or phenobarbital non-folic acid deficiency anemia’s (eg, pernicious anemia)

Pregnancy: Folic acid is often prescribed during pregnancy and is safe when used as directed. Folic acid requirements are markedly increased during pregnancy, and deficiency will likely result in fetal damage.

Breastfeeding: Folic acid appears in breast milk. Usually, amounts present in breast milk are adequate to fulfill infant requirements, but the lactating mother may require folic acid supplementation. Consult your doctor before you begin breastfeeding.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or if you are planning to take any over-the-counter or prescription medications or dietary supplements with folic acid. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed.

• Alcohol hydantoins (eg, phenytoin)
• Antimetabolites (eg, methotrexate)
• Primidone (eg, Mysoline)
• Nitrofurantoin (eg, Furadantin)

Side Effects:

Every drug is capable of producing side effects. Many folic acid users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include: Difficulty breathing; itching; skin redness or rash; general body discomfort; flushing.

In higher doses (15 mg/day), additional possible side effects include: Los, of appetite; nausea; stomach bloating or swelling; gas; bitter or bad taste, altered sleep patterns; difficulty in concentrating; irritability; over ­activity; excitement; depression; confusion; impaired judgment; decreased vitamin 8 12 levels (in patients receiving prolonged therapy).

Guidelines for Use:

• Take only when recommended by your doctor .
• Treatment of Anemia - Usual therapeutic (treatment) dose for anemia: Up to 1 mg daily. Usual maintenance dose once amenia has been corrected: Infants: 0.1 mg/day. Children under 4 years of age: Up to 0.3 mg/day. Adults and children over 4 years of age: 0.4 mg/day. Pregnant and breastfeeding women: 0.8 mg/day.
• In the presence of alcoholism, hemolytic anemia, anticonvulsant therapy, or chronic infection, the maintenance dose may need to be increased.
• Except during pregnancy and lactation, folic acid should not be given in doses greater than 0.4 mg/day until pernicious anemia has been ruled out.
• Oral administration is preferred. Intramuscular, intravenous, and subcutaneous routes may be used if the disease is severe, or if oral absorption is impaired.
• Store at room temperature (59 to 86°F). Protect from light and moisture.

Vitamin B - Type of Drug - Some Interactions occurring with Vitamin B

Type of Drug:

Water-soluble vitamin. Vitamin that can be stored by the body. Vitamin 8′2 includes cyanocobalamin and hydroxocobalamin.

How the Vitamin B Works:

Vitamin 8′2 is needed for normal growth and reproduction of red blood cells, muscle and nerve tissue. It is usually adequately provided by the diet.

Uses of Vitamin B :

To treat diagnosed vitamin 8′2 deficiency that may be due to pernicious anemia, inadequate diet, digestion disorders (sprue), trauma, surgery, cancer or infections.

Vitamin B requirements may increase during pregnancy, in vegetarians, after blood loss, during illnesses involving the liver and kidneys, in hemolytic anemia and in thyrotoxicosis.

Unlabeled Uses: Occasionally doctors may prescribe hydroxocobalamin for cyanide poisoning associated with sodium nitroprusside.

Precautions:

Do not use in the following situations: allergy to cobalt allergy to vitamin 8′2 or any component of the formulation

Use with caution in the following situations: bone marrow suppressant drugs iron deficiency (eg, chloramphenicol) Leber disease folic acid deficiency polycythemia vera infection uremia

Eye problems: Use of vitamin 8′2 may worsen Leber disease, a rare hereditary eye condition.

Single deficiency (vitamin 8′2 alone) is rare. Expect multiple vitamin deficiency in finny dietary deficiency.

Pregnancy: Adequate studies have not been done in pregnant women. However ,B12 is an essential vitamin and needs me increased during pregnancy.

Breastfeeding: Vitamin B 12 appears in breast milk. Consult your doctor before you begin breastfeeding .

Lab tests may be necessary to determine progress of therapy.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over-­the-counter or prescription medications or dietary supplements while taking this drug. Doses of one or both drugs may need to be modified or a different drug may need to be prescribed. The following drugs and drug classes interact with this drug:

• Alcohol (excessive intake)
• Aminosalicylic acid (Paser)
• Chloramphenicol (eg, Chloromy-cetin)

Side Effects of Vitamin B:

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Inject able vitamin B : Discomfort following injection; pain at injection site; blood clots in arms or legs; breathing difficulties; congestive heart failure; anaphylactic shock; death.

Skin: Rash; itching; hives; bruising.

Other: Fever; vision difficulties; feeling of swelling of the entire body; mild diarrhea; abnormal blood counts.

Guidelines for Use:

• Recommended Dietary Allowance (RDA) ­ Adult males: 2 mcg Adult females: 2 mcg Pregnant women: 2.2 mcg Breastfeeding women: 2.6 mcg Infants and children: 0.3 to 2 mcg Doses larger than the RDA are used to treat vitamin B 12 deficiency.
• A well-balanced diet is necessary. Correct poor eating habits. Strict vegetarian diets containing no animal products (including milk products and eggs) do not supply vitamin B 12 . Vegetarians should take vitamin B 12 supplements regularly.
• Common sources of vitamin 8 12 - Meat, liver.
• Initially, vitamin B 12 may be given daily.
• In some cases, vitamin B 12 must be continued indefinitely to prevent the return of anemia and to prevent damage to the central nervous system.
• Although oral dosing of vitamin B 12 is convenient, injections may be required.
• Folic acid is sometimes taken with vitamin B 12 but is not a substitute for it. In pernicious anemia, folic acid may effectively return the blood profile to normal while nerve damage due to vitamin B 12 deficiency progresses.