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The proportion of cardiac catheterization patients with SGLT2 inhibitor prescriptions before the procedure showed modest but steady growth, increasing from 0.5% in 2018 to 1.6% in 2023 (Figure 4)

So if you took B12 and felt worse, and your blood B12 is elevated, and you have a constellation of symptoms across multiple systems that's three signals pointing toward MCAS as worth ruling out

What you are seeing is intracellular water retention in muscle tissue

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