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If GP is ignoring you, have you thought about writing a short letter with your concerns

This patient has four simultaneous factors compromising b12 status, making supplementation prudent even with normal baseline levels

Obesity, for example, is associated with increased aromatization of testosterone into estrogen, which may necessitate careful dose titration and monitoring

This balanced approach can harness the benefits while minimizing uncertainties

They concluded that SSZ is not an efficient folate antagonist in vivo [20]

However, B12 deficiency often affects females of reproductive age, and can cause complications during pregnancy and nursing