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Moreover, research found that in liver cancer patients, selenium metabolism in CD8+ T cells and NK cells within tumor tissues is abnormal, characterized by increased SEPP1 and decreased SELENBP (133, 134) ( Figure 2 )

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But findings from cachexia trials are mixed (11) (50) (58)

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Metformin use and risk of B12 deficiency increases with the dose and the duration depletion can be seen as early as 3-4 months after starting so it is important to attend for follow up blood tests and talk to your doctor