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This effect is likely a specific aspect of the dual role of the NO system (L-NAME vs

You might remember from biology class that amino acids are the building blocks of proteins

The risk is much higher in men and women with gonadal dysgenesis, specially forms that arise from early gonadal differentiation defects, such as mutations in SRY and WT1, than in individuals with ovotesticular DSD or with hormone synthesis or action disorders (for example, androgen insensitivity) [168,169,170]

You do however have pernicious anemia & all of your symptoms are caused by that

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Maintenance: Once youve achieved your desired results, we can discuss options for maintaining your weight loss, which might include periodic booster injections or ongoing lifestyle adjustments