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Because it acts locally on growth factor pathways rather than endocrine receptors, typical side effects are restricted to localized injection site irritation or mild transit shifts in bowel motility models

Elevated homocysteine and methylmalonic acid (MMA) are biomarkers of functional B12 insufficiency

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Naltrexone, in a very low dose (typically 1.5 to 4.5 mg), briefly blocks opioid receptors in the brain and on immune cells for a few hours overnight

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