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This is not unheard of, as drugs like pioglitazone and acipimox both reduce metabolic complications without treating obesity at all

You are experiencing unexplained symptoms like fatigue, nausea, dizziness, or skin changes

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Pernicious anemia can sneak up on you

Cerebral atrophy in 21 hypotonic infants with severe vitamin B 12 deficiency

Note: High vitamin B12 levels symptoms are not always obvious, but some individuals may experience discomfort like dizziness or nausea