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This orexigenic drive appears to be largely GH-independent, as it is observed even in models of GH-deficiency, and is accompanied by rises in leptin that likely reflect expansion of adipose depots and provide a feedback brake on further hyperphagia

The NHS treatment pathway and the 2024 NICE guideline both assume B12 injections are given in a clinical setting against a confirmed deficiency, not self-sourced and self-administered

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65% 96% 26 A1C 7.0% .174 , , T2DM 3