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Many people feel fatigued because they are mildly dehydrated and depleted in sodium, potassium, and magnesium, not because they need b12
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For severe cases, the first dose is usually 1,000 mcg given intramuscularly every day or every other day for a week or two

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Healthcare professionals should maintain vigilance regarding these intersecting risk factors when managing patients on GLP-1 receptor agonists
