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Before starting any patient on a Phentermine regimen, we conduct a thorough medical evaluation, including a review of medical history and current medications, to ensure the drug will not cause adverse reactions

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Precautions General Precautions: Vitamin B 12 deficiency that is allowed to progress for longer than 3 months may produce permanent degenerative lesions of the spinal cord

A patient with impaired absorption can maintain a borderline-normal serum level for a long time while their cellular B12 is progressively inadequate