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There is a certain type of anemia associated with too much B12, and so clearly, a physician should be ordering the medication, and should follow the patient closely for any problems

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Hormones such as progesterone, estrogen, and testosterone can all contribute to insomnia especially in premenstrual women, pregnant women, and women in menopause but those problems are temporary and resolve once hormone levels return to normal

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That is a substantial rate for a side effect that neither semaglutide nor tirzepatide produces at any meaningful frequency