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Comprehensive medical assessment before initiating treatment remains essential, as clinical trial populations never fully represent the diversity of health conditions encountered in practice

Lifestyle adjustments include eating small amounts of nutrient-dense foods even when appetite is suppressed, avoiding caffeine or reducing intake gradually (caffeine withdrawal itself can cause headaches), and maintaining consistent sleep and meal timing

Pain 160:S17S22

Furthermore, there were no significant negative impacts on liver function, renal function, hematology, or vital signsduring or after the supplementation period Supplementary Tables 24

Malabsorption can cause severe B12 deficiency

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