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However, prolonged use beyond 612 months without periodic metabolic panel monitoring can mask underlying nutritional deficiencies or liver dysfunction, which is why medically supervised protocols include quarterly bloodwork to assess hepatic enzyme levels (ALT, AST) and lipid panels

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As a result, your BAC levels may rise more slowly than if you were adequately hydrated

Also, certain medications, like proton pump inhibitors and metformin, might affect B12 absorption