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Of course it is also widely known that cortisone shots have a negative long term effects on the health of the tendon compared to prolotherapy

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It appears to have both local and systemic effects depending on route of administration subcutaneous injection, oral supplementation (though oral bioavailability is debated), and local injection into injured tissue have all been studied in animal models

This means that high serum B12 levels can persist for some time after large supplemental doses