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If it does not drop or if your symptoms have not improved after 12 weeks on the protocol the problem was probably not MTHFR
Friedman does not recommend GLP-1s in patients with low muscle mass to begin with

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Vertical sleeve gastrectomy Like the gastric bypass, the vertical sleeve gastrectomy is a procedure that reduces the size of your stomach, resulting in a feeling of fullness after eating a smaller amount of food

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