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Nasal spray delivers lower bioavailability than injection, typically 40-60% compared to 80-95% for subcutaneous administration

Mar 15 2012;131(2):387-396

Their combined effect in non-diabetic adults has not been tested in a phase 3 trial

Many providers use them together because they may support different aspects of the healing process

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Some people do have difficulties ingesting supplements, at which point a higher dosage can be prescribed (up to 10,000 mcg) by your doctor, in order to ensure you are getting the sufficient levels your body needs