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[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes

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Their mechanisms range from anti-inflammatory and regenerative effects to microbiome modulation

GLP-1 protocols produce greater total weight loss (1220% body weight) but include lean mass loss and require ongoing administration to prevent rebound

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Symptoms like bloating, discomfort, or irregular bowel patterns often improve within 2-3 weeks