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Silverstein said he decided to investigate the over-prescribing of B12 shots, because "as an internal medicine resident, I have seen many patients come into the emergency department, and they were getting B12 injections without having a really good reason for it." His study could not determine why family physicians were prescribing it inappropriately including whether it was initiated by the doctor or at the request of the patient

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If constipation lasts longer than three weeks, keeps coming back, or stops responding to things that used to help, a doctor can look for underlying causes and tailor treatment

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