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Unlike B12 deficiency, which produces recognisable neurological and haematological symptoms, excess vitamin B12 typically remains asymptomatic and is discovered incidentally during routine blood tests

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It enrolled between 502 and 536 obese adults across multiple sites, more than fifteen times the group size of the first trial, and treated them for 24 weeks, twice as long, with oral tablets at 0.25, 0.5, or 1 milligram daily against placebo