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If symptoms persist despite regular oral supplementation, absorption may be limited
It is possible that compensatory mechanisms could develop that reduce efficacy with prolonged use
If levels decline, adding b12 becomes appropriate with clear justification
Some patients feel an energy boost within a few days, while others with severe neurological symptoms may take several weeks of treatment before noticing improvement
Gibbons, G
These medications work primarily through central appetite suppression, delayed gastric emptying, and enhanced satiety signaling
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