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Additionally, a Cochrane review indicated that selenium supplementation may have potential benefits for patients with Hashimotos thyroiditis by reducing antibody levels and associated symptoms such as drowsiness, asthenia, and mood swings [35]

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Discoloration (yellowing), crystallization patterns, or collapsed cake may indicate degradation or moisture exposure

Conditions such as Crohns, coeliac disease or previous gut surgery, and the autoimmune cause behind pernicious anaemia, all affect how well you retain B12