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Genuine choline deficiency contributes to hepatic fat accumulation which is exactly why choline is in the blend and why the fat-metabolism story sounds plausible

Others point to dehydration, since increased lipolysis generates metabolic water demands

How is the condition diagnosed

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In these cases, your GP should arrange intramuscular hydroxocobalamin injections according to NICE guidelines, with the regimen depending on whether neurological symptoms are present (as detailed in the previous section)