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Members of the TGF-$\beta$ family often act as primary triggers for catagen (involution) phase entry and localized follicle regression
Summary: High vitamin B12 levels rarely cause direct symptoms
Critically, the study documented no significant changes in oral glucose tolerance tests, no alterations in fasting insulin levels, and no changes in serum IGF-1 concentrations across all treatment groups
The main reason is metformin, the first-line medicine for type 2 diabetes, which can reduce how well the gut absorbs vitamin B12 over time
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