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If your diet includes no meat or fish, and minimal dairy, your B12 is almost certainly falling short

Beyond weight loss, B12 shots are also beneficial for improving mood and concentration, which can help maintain motivation during a weight loss journey

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This phenomenon, sometimes referred to as early worsening of diabetic retinopathy, appears to be related to the magnitude and speed of glucose lowering rather than a direct effect of the medication

The mechanism is plausible: dopamine D2 receptor modulation and serotonergic interactions can shift the neurotransmitter balance toward wakefulness