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Vegans and vegetarians are particularly at risk for B12 deficiency because plant-based foods do not naturally contain vitamin B12

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Gastrointestinal side effects are the most common adverse events, which usually occur during the dose escalation period and then decrease over time

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Furthermore, smoking induces vascular vasoconstriction, sinusoidal endothelial dysfunction, and smooth muscle proliferation, leading to hypoxia, capillarization of sinusoids, and further activation of HSCs [18]