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In pathophysiological states, including increased insulin resistance, the hybrid receptor number is changed significantly, thus potentially abrogating the chance for IGF-1 to alter glucose metabolism [129, 132, 133]
the elderly, strict vegetarians (i.e., vegan), and patients with malabsorption problems are more likely to become deficient
B vitamins
Patients with pernicious anemia who face B12 absorption problems need alternative treatment approaches since their bodies need longer to react to therapeutic interventions
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