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This condition is often due to autoimmune diseases like Hashimotos thyroiditis or iodine deficiency
doi:10.1017/s1463423619000227 Alpert JS
I eventually wrung it out of her, and commented that serum B12 wouldn't be a bad idea [not on B12, and 73yrs old] and got a further evasion
More recently it has been demonstrated that these changes mediate a beneficial effect in models of T2D diabetes
It carries potential risks, especially if misused
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