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A patient who failed progestin therapy might respond when GLP-1 agonism restores the receptor expression those progestins need to work

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There is around a 2.5-fold increase in B12 deficiency incidence in those treated with metformin, and this may occur as early as 3 months, although hepatic stores of vitamin B12 may take 5 years or more to deplete (Bell, 2022)

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When a true vitamin B12 deficiency exists, serious issues can arise

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