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However, anecdotal reports suggest that women may experience more pronounced nausea at the 4mg and 8mg dose steps, particularly around menstruation when hormonal fluctuations can amplify GI sensitivity

The most common sign of pancreatitis is severe, persistent pain in the upper-middle abdomen that may radiate to the back

These reactions are typically mild, self-limiting, and resolve without intervention

Vegans or people who eat very little animal products might not get enough B12 from their diet

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Mesas et al., 2018)