Recommendations for diagnosis and management of metformin-induced vitamin B12 (Cbl) deficiency
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The fragment does not bind the growth hormone receptor or activate the JAK2-STAT5 signaling pathway

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Conservative treatments include medications (e.g., steroids, vitamin B12, non-steroidal anti-inflammatory drugs [NSAID], and gabapentin), splint, and physiotherapy 4
Or, perhaps more optimistically, could they work together