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This is an honest limitation of the current evidence base
The cause is multifactorial: reduced caloric intake, slower gastric emptying, mild dehydration if water intake drops with appetite, and elevated B12 demand during a rapid metabolic shift
In pediatric GH deficiency: significant improvements in height velocity and growth parameters over 612 months [1]
I build it into serums at clinically supported percentages, and I often pair it with hydrators (hyaluronic acid) and barrier supporters (niacinamide, ceramides) to balance activity with comfort
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