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Serum homocysteine and methylmalonic acid levels are also high in B 12 deficiency and can be helpful if the diagnosis is unclear
This strategy mirrors the approach used with GLP-1 maintenance dosing , where starting low and titrating up reduces side effects across the board
Aim to chew food approximately 20-30x per bite, and have meal time last closer to 20 minutes
doi: 10.1016/j.biochi.2023.04.018 48
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