l carnitine cardiovascular disease L-Carnitine & Arterial Plaque Red Meat and Heart Disease:

At-risk groups, including the elderly, vegetarians, vegans, and individuals with gastrointestinal disorders, may need B12 injections for deficiency prevention

The honest caveat: most evidence comes from animal studies

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I only use it once a day for four years, but I tell people to use it twice a day, because the thing is I never form a routine for myself