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Because of this property, deficiency in B vitamins can manifest as low energy, slow metabolism, fatigue, brain fog, and low mood

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These include men who follow strict vegetarian or vegan diets (especially for B12), those with chronic digestive issues that affect nutrient absorption, and men over 50 whose absorption naturally decreases with age

Medical management is key to prevention progressive disease, but surgical management is usually necessary when a person has painful joint destruction and/or tendon ruptures