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Potential concerns include chronic skin changes and cardiovascular strain

Older adults face increased risks of gastrointestinal side effects, dehydration, sarcopenia, and drug interactions requiring careful monitoring

Pyridoxine is also considered safe during lactation in normal amounts, although exceedingly high doses might transiently suppress prolactin levels and were historically used (in much larger doses than nutritional needs) to suppress lactation

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In most clinical studies, fewer than 5% of participants reported a yeast infection

Cohort definition and longitudinal structure Eligibility criteria were defined to ensure valid longitudinal inference and consistent survival endpoints