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This complex process means that conditions affecting the stomach or intestines can significantly impair B12 absorption, including pernicious anaemia, atrophic gastritis, previous gastric surgery, coeliac disease, Crohn's disease, and long-term use of certain medications (such as metformin, proton pump inhibitors, and H2 antagonists)
Most patients notice the first changes within two weeks: Pain reduction and decreased inflammation come first, followed by improved range of motion and faster recovery as the protocol progresses
As noted, untreated hypothyroidism will interfere with sermorelins effects
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