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Mol Metab 2022;65:101590.ArticlePubMedPMC 80

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Common red flags: Persistent fatigue Hair thinning beyond expected telogen shift Neuropathy or tingling Muscle weakness Persistent vomiting or diarrhoea If YES Laboratory assessment appropriate If NO Continue structured dietary strategy Step 5: Are High-Risk Factors Present

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This gives each site a full month to recover between injections