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Because most of the B12 in our diet comes from animal products, vegan eaters are especially at risk of developing a B12 deficiency
The NEJM article discusses people who had strong reactions to dose 1 and what they did to counter them
The organization focuses specifically on obesity as a disease requiring medical management

These antidepressants inhibit the liver enzyme CYP2D6, which is crucial for metabolizing Tramadol
