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Additionally, some individuals have genetic variations that affect B12 metabolism
The hypothalamic-pituitary-gonadal axis responds positively to certain peptides that stimulate natural hormone production
Some patients also had hematologic abnormalities, that while they did not necessitate discontinuation or a dose decrease, did cause the researchers to recommend monthly blood cell counts for safety purposes
There is also potential for more as there is no data past 48 weeks as of yet
Nature (2004) 6
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