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Either way, it is often caused by a deficiency in vitamin B12

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IGF-1 and its analogs including IGF-1 LR3 are listed under S2 (Peptide Hormones, Growth Factors, Related Substances and Mimetics) and are prohibited at all times, in and out of competition

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Those who maintain a vegan diet are also at high risk of developing a vitamin B12 deficiency since meats and other animal by-products are some of the best sources of B12