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21 The Institute of Medicine recommends daily consumption of 2.4 mcg of vitamin B 12 in adults older than 18 years to prevent vitamin B 12 deficiency

While menstrual irregularities were not systematically reported as adverse events in published results, the substantial weight loss achieved (approximately 20.9% with the 15 mg dose) would be expected to influence reproductive hormone dynamics in premenopausal women based on established weight loss physiology

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