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It may be related to nutritional deficiency or endocrine conditions such as diabetes mellitus

Vitamin D deficiency is common, in part because people who are sick tend to stay at home and not get enough sunshine

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Retrieved from Yoshida, Y., Sumikawa, M., Sugimori, H., & Yano, R

Avoid Rapid Dose Escalation Increasing doses too quickly may increase the chance of nausea, fatigue, or headaches
