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In theory this is because circulation during exertion was directed to muscles instead of fatty tissues

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2024;36: e2311283

Of note, rifaximin significantly suppressed the decrease in the IGF-1 level, corroborating the likelihood that rifaximin could also prevent sarcopenia by shielding from exposure to gut-derived LPS

Doctors I have visited they don't have any information regarding this neurological symptoms problem due to pernicous aneamia and they didn't even ask for proper test before injection like methylmalonic acid and hemocystien test and IFab test