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When a person with Down syndrome has vitamin B12 and/or folate deficiency, the increase in the homocysteine level may not be great enough to overcome this starting low value of homocysteine

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If you switch from a compounded semaglutide with B12 to a formulation without it (or to brand-name Wegovy, which does not contain B12), you need to add B12 supplementation separately

it is whether they get a meaningful amount of the vitamin at all

1 2 "Map: Count of Nutrients In Fortification Standards"