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Sorry if that's not what you were hoping for, but as you say, it seems to be the most stubborn symptom for sure

Consider B 12 supplementation without testing in asymptomatic patients with risk factors for B 12 deficiency (see Table 1: Patient Risk Factors Associated with B 12 Deficiency)

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Sufficient B12 in the diet lowers the risk of age-related macular degeneration

If you are following a semaglutide dosage chart and your protocol spans several weeks, this 28-day window after first use becomes the practical limiting factor