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Water-soluble vitamin deficiencies are less common in well-nourished populations but can occur with alcohol use disorder, malabsorption conditions, strict veganism (particularly for B12), or prolonged poor dietary intake

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It is highly resistant to enzymatic degradation, allowing it to exert its effects across various organ systems even when administered systemically

Persistent nausea, reflux, constipation, rising resting heart rate, or broken sleep shows that the current dose has not settled