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The medication works by tricking the body into thinking its not getting enough estrogen, which stimulates the production of luteinizing hormone (LH) and follicle stimulating hormone (FSH) in the hypothalamus and pituitary gland in the brain

24 In a clinically symptomatic patient with specific features of B 12 deficiency, order a B 12 test, see Figure1: B 12 Test Result Review and Process Algorithm for Patients with Risk Factor for B 12 Deficiency* and/or Non- Specific** or Specific Symptom of B 12 Deficiency for more detail

doi: 10.1172/jci.insight.154089 146 ZhangHLiuJYuanWZhangQLuoXLiYet al