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People who are on certain dietary restrictions, especially vegans and those undergoing a weight loss regimen, may have a higher chance of developing vitamin B12 deficiency

The answers are layered

In an environment with elevated CD38 activity, such as seen in SSc lesional skin, administering NAD + precursors or enhancing NAD + synthesis will have limited effect on increasing NAD + levels, as elevated CD38 continues to degrade NAD +

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The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect

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