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SAM is an all-purpose methyl group donor that participates as a co-factor in a variety of physiological and cellular processes, including lipid homeostasis

Serious problems can begin to arise with only a slight B12 deficiency

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B-5 (pantothenic acid) and B-2 (riboflavin) also help metabolize nutrients

However, these patients had multiple risk factors for b12 deficiency beyond semaglutide use, including previous gastric surgery that permanently alters stomach anatomy and reduces intrinsic factor production

Additional hormone replacement can make these results more noticeable