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Toxin and drug exposure Some also hypothesise that toxin exposure could trigger ME/CFS (61), such as organophosphate compounds (152, 153) and heavy metals (154)

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This knowledge also explains why oral B12 supplementation may be ineffective in intrinsic factor deficiency, requiring alternative routes like sublingual, nasal, or injectable B12 to bypass the intrinsic factor-dependent absorption pathway

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Pharmaceutical Benefits of Fluticasone Propionate Association to Delivery Systems: In Vitro and In Vivo Evaluation