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In longer studies, around half of the participants lost 15% of their body weight at 68 weeks, and nearly a third lost 20%

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However, persistently high serum B12 levels warrant medical investigation, as they may indicate liver disease, kidney dysfunction, or haematological disorders rather than simple overconsumption

This is especially important for patients with diagnosed deficiencies, pernicious anemia, or for those who have undergone bariatric surgery

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However, it is typically refrigerated and used within a week