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Nausea (reported by up to 44% on higher doses ), bloating , burping , and constipation all contribute to increased reflux risk through different mechanisms

It effectively tricks your body into thinking it should not start menstruation, by maintaining higher levels of progesterone

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Propionate, itself a substrate for intestinal gluconeogenesis, activates its expression via a gut-brain neural circuit involving the fatty acid receptor FFAR3 (245)

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Cyanocobalamin must first get converted into hydroxocobalamin before the body can actually use it