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It is less commonly prescribed than levothyroxine but is sometimes used in combination with it

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Another autoimmune disease, atrophic gastritis, thins the lining of your stomach and prevents your body from making enough hydrochloric acid and intrinsic factor you need to absorb B12

[Crossref] Schmidt TS, Alp NJ (2007) Mechanisms for the role of tetrahydrobiopterin in endothelial function and vascular disease