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A B12 deficiency can lead to anemia, which may cause symptoms such as weakness, dizziness, and low energy levels, significantly affecting overall well-being

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In the case of pronounced absorption disorders, for example as a result of gastritis or after removal of the small intestine, in Crohn's disease, diverticulosis and the so-called blind-loop syndrome, there is a gradual decrease in the vitamin B12 store in the liver, which can turn into a manifest vitamin B12 deficiency

This combination may require additional estrogen management compared to TRT alone