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Issues like cost, availability, side effects (such as nausea), and the simple fact that obesity is a complex condition drive the search for other solutions

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TB-500 : Side effects are typically mild and include injection site discomfort, mild lethargy or head rush shortly after administration (due to systemic effect), and, anecdotally, temporary redness or swelling near the injection site

That number gets even worse if you have hypothyroidism (up to 50% of these patients have B12 deficiency)