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Low Energy Persistent fatigue that doesnt improve with rest is often a sign of B vitamin deficiency

Do not wait for routine labs Severe abdominal pain, persistent vomiting, fainting, dehydration, chest pain, or allergic symptoms need medical review
Similarly, Monje et al

On the microscopic histology scale, tendinopathy is seen as disorganized collagen fibrils, increase in mucoid ground substance, changes in collagen subtype expression, random neovascularization, focal necrosis, fibrocartilaginous metaplasia, calcification, and interstitial tearing