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However, both compounds individually cause: Nausea (60-80% of users at higher doses) Vomiting (20-35%) Diarrhea (25-40%) Injection site reactions (15-25%) Potential pancreatitis (rare but serious) Combining these compounds could theoretically amplify these effects, though the actual incidence and severity remain unstudied
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Diagnosis integrates clinical symptoms, B12 levels (or active B12/MMA/homocysteine where appropriate), antibody results, and exclusion of other causes
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