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Hopefully the dermatologist I see will have some familiarity or understanding of this

Be aware that sublingual B-12 supplements often contain sugar substitutes such as sorbitol, mannitol or sucralose, which can cause gastrointestinal symptoms in some people

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212 Nevertheless, semen analysis does not identify all male infertility cases, since even in the context of normal findings, sperm may be unable to reach the female germ cell, fertilize it, or contribute to a healthy pregnancy

(PubMed) Sharabi A, Cohen E, Sulkes J, Garty M