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The 2% extra lean-mass loss at 12 months sounds small until you scale it: on a 100 kg starting weight with 25% body fat (25 kg fat, 75 kg lean), an extra 2% lean mass equals 1.5 kg of additional muscle attrition over a year roughly one full year of natural aging muscle loss, on top of whatever the drug class is already costing you

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B12 deficiency is one of the reasons I sometimes push a surgical date back, and I want to be transparent about when and why