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But plant foods said to contain B12 actually contain B12 analogs called cobamides that block the intake of and increase the need of true B12'

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However, tesofensine faces significant challenges - cardiovascular side effects (increased heart rate and blood pressure) raised safety concerns, FDA has not approved it despite promising efficacy data, development stalled after Phase 3 trials, currently available only through research chemical suppliers with questionable legality, and the stimulant-like mechanism creates dependency and tolerance risks not seen with GLP-1 agonists