In some extreme cases, there has been evidence of tingling sensation and even chest pains in those lacking B12
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(2013) showed that the ginseng intake (250 mg/twice daily), significantly improves the quality of life and reduces the level of fatigue in MS patients, while a single center randomized double-blind placebo-controlled crossover pilot study conducted enrolling 56 patients showed that American ginseng extract was safe but ineffective for treating MS fatigue (Kim et al., 2011)
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