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Its entire published human evidence base is two small early-phase pharmacokinetic studies from the mid-2000s that measured GH and IGF-1 as surrogate markers not a single controlled efficacy trial with a disease endpoint

Because of this and the fact that the body only needs a small amount of vitamin B12 each day, it can take up to a year or even longer for an inadequate vitamin B12 to manifest as an apparent deficiency

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