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This dietary pattern change may contribute to declining b12 levels as much as or more than any absorption issue

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Options include a dose adjustment, adding a GLP-1 medication as dual therapy, addressing sleep, or modifying diet and exercise

Chronic tennis elbow often presents with pain that has been present for six months or longer, structural changes visible on ultrasound or MRI, decreased grip strength, pain at rest in addition to activity, and previous failed treatments

Best of luck.