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can b12 injections cause back pain Vitamin Deficiency: A Fact Sheet on Signs, Treatment and Benefits Vitamin B12 Deficiency & Nerve
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J Clin Endocrinol Metab 85 : 16861694 Rose DR and Clemmons DR (2002) Growth hormone receptor antagonist improves insulin resistance in acromegaly

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Your body becomes unable to produce energy when your B12 levels decrease, which leads to persistent fatigue despite getting enough rest
For example, how bad the deficiency is, or if the body cant absorb it well