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Common causes include liver disease (which releases stored B12), kidney disease (reducing B12 clearance), haematological malignancies, solid tumours, and excessive supplementation

Instead of overcoming the metabolic adaptation, higher doses frequently exacerbate side effects like nausea, fatigue, and gastrointestinal distress

Serious side effects such as pancreatitis or thyroid complications are extremely rare but require immediate medical attention if they occur

Tesofensine offers a compelling tool for athletes, competitors, and serious dieters who struggle with hunger, adherence, or energy during cutting phases