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Always consult with a qualified healthcare provider before starting any new supplement, especially if you are pregnant, nursing, taking medications, or have an underlying medical condition.

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(PubMed) Gunton JE, Hams G, Hitchman R, McElduff A

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So if you took B12 and felt worse, and your blood B12 is elevated, and you have a constellation of symptoms across multiple systems that's three signals pointing toward MCAS as worth ruling out