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Low trauma fractures were more common and appeared as early as 12 weeks after starting the drug

Consider B 12 supplementation without testing in asymptomatic patients with risk factors for B 12 deficiency (see Table 1: Patient Risk Factors Associated with B 12 Deficiency)

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Conditions of GH excess (such as acromegaly), active carpal tunnel syndrome, pregnancy and breastfeeding, and pediatric use are all situations where this class is avoided