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Certain individuals are at a higher risk for B12 deficiencyincluding those following strict vegan or vegetarian diets, as well as patients with conditions that impair nutrient absorption, such as pernicious anemia, celiac disease, Crohns disease, or a history of gastrointestinal surgery

These findings suggest that combining the treatment with exercise produces an additive enhancement of muscle strength better than either exercising or using the treatment alone

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Lipotropic injections may be used as a supportive therapy alongside these measures when clinically appropriate