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Systemic effects less commonly include mild dizziness or lightheadedness (may be copper-related), temporary nausea or headache (typically resolves within hours), mild fatigue (rare, reported with higher doses), and transient flu-like symptoms (very rare, may relate to systemic inflammatory response)

(1996) [Effect of vitamin B12 on sleep quality and performance of shift workers]

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167 These pathways, which are normally active in embryonic development and tissue homeostasis, are frequently dysregulated in CSCs, thereby promoting tumor progression and therapy resistance

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