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So, there seems a possibility it is autoimmune BUT what about the low meat intake

The lack of adequate vitamin B12 from sources such as meat, eggs, and dairy, can lead to deficiencies causing anemia, intestinal issues, and other medical conditions

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Typical Generic Supplier Imported Bacteriostatic Water Often Overseas Unverified Often Sourced Overseas Many online sellers source from unidentified overseas manufacturers with no auditable supply chain

Add semaglutide to the mix and the decline accelerates