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Vitamin B12 Deficiency Causes of vitamin B12 deficiency include difficulty absorbing vitamin B12 from food, lack of intrinsic factor (e.g., because of pernicious anemia), surgery in the gastrointestinal tract, prolonged use of certain medications (e.g., metformin or proton pump inhibitors), and dietary deficiency

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Beyond pigmentation, it also tends to suppress appetite and can cause modest weight loss , and it has a dose-dependent effect on libido (RevitalyzeMD)

TB-500 is likewise not FDA-approved for any indication

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