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Their use should be limited to clear medical indications—type 2 diabetes, obesity, insulin resistance, or elevated cardiometabolic risk—and always integrated into a care plan that considers a woman’s reproductive goals, hormonal therapies, and individual symptom profile

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It is dispensed in amber multidose vials containing 1,000 mcg/mL and compounded for use under either section 503A or 503B, allowing clinicians to individualize therapy for deficiency states ranging from pernicious anemia to postsurgical malabsorption