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This letter in a narrow respect validates, at least anecdodately, the core argument firms like Novo Nordisk and Eli Lilly are making: that compounded versions of their drugs, produced outside a more robust CGMP framework, carry real and documented patient safety risks

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Thus the CA BOP is superseding the FDA in a major way

Because B12 plays a crucial role in energy production, correcting a deficiency can reduce fatigue and indirectly support weight loss by helping people feel more active