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Start too aggressively and gastrointestinal side effects can become debilitating
For other confirmed or suspected malabsorption, vitamin B12 replacement should be offered and intramuscular treatment should be considered instead of oral treatment
Injection site reactions occur in approximately 5 to 10% of users
Notably, body weight loss was correlated to increased abundance of Akkermansia muciniphila , a mucin-degrading SCFA-producing species which has been reported decreased in obesity and show negative correlation to markers of gut permeability and inflammation 70
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