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A couple of studies found no benefits of B12 for lowering homocysteine in HD patients, one used oral B12, 2000 g three times per week for 6 weeks, 55 the other used methyl-B12 i.m

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Patients taking these combinations require careful glucose monitoring and may need dose reductions of insulin or sulfonylureas when starting tirzepatide

Lost about a pound a week, which is great for me especially feeling like it was effortless :)