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In my case Im beginning to think it was my Lyme disease as "they say" I don't have Lupus

It typically presents as macrocytic megaloblastic anemia and neurological impairments, including sensory and motor disfunctions, predominantly in the lower extremities, ataxia, and in more advanced stages cognitive decline progressing to dementia, as well as psychiatric disturbances (Green et al., 2017)

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Once opened, refrigeration is usually recommended to prevent microbial growth, even if the unopened product did not require cold storage

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