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The compound appears well-tolerated in animals at doses well above those producing metabolic effects

Having a weak core muscle area can have a similar effect on the lumbar and trunk biomechanics as a stiff or loose lumbar spine and can also lead to pain in the piriformis muscle

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o Consult your doctor before combining these medications

A recent meta-analysis found treatment with metformin to be significantly associated with an increased incidence of vitamin B12 deficiency and reduced serum levels.8 It is therefore possible that the etiology in this case may have been twofold

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