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Many women experience menstrual irregularities during the first 3-6 months of treatment
The most performance-relevant outcome is improved oxygen delivery, because B12 deficiency directly causes anemia and reduced VO2 max regardless of training
The broader trend in research points toward mental health improvement, not deterioration
Background antidiabetic therapy included OADs and/or insulin
For gallbladder-free patients, this slower transit can actually be beneficial, as it reduces the sudden, large load of fat entering the intestine all at once
The mechanism appears to involve both central nervous system effects (direct brain receptor activation) and peripheral effects (changes in metabolic hormones that communicate with the brain)
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