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Patients experiencing persistent gastrointestinal adverse effects may benefit from slower titration schedules or maintaining lower doses for longer periods before attempting escalation
It was among the first reports of a small molecule reproducing the metabolic effects seen with earlier NNMT-blocking approaches
However, risk factors include: a family history of pernicious anemia a family history of other autoimmune disorders, such as vitiligo and Addisons disease being female older age Pernicious anemia is a common cause of vitamin B12 deficiency
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