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They reason that hydroxocobalamin is not a psychoactive substance or a synthetic chemical drug

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In lab and clinical research, its been observed to activate fibroblasts (the cells that produce collagen), increase glycosaminoglycan synthesis (which helps skin retain water), modulate matrix metalloproteinases (MMPs, the enzymes that break down old tissue), and act as a copper cofactor in antioxidant pathways

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Diarrhea or constipation Digestive changes occur as semaglutide slows gastric emptying