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But caloric restriction, combined with the reduced nutrient density of a smaller total food volume, creates conditions where B vitamins including B12 become limiting factors for mitochondrial energy production

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More serious but less common side effects to watch for at this dose include acute pancreatitis (symptoms: severe abdominal pain radiating to the back, nausea, vomiting), gallbladder problems (symptoms: sudden pain in the upper right abdomen, fever, jaundice), and significant hypoglycemia if combined with certain diabetes medications