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However, they may also be pasteurised (which kills the live bacteria) unless they are kept in the refrigerated section and labelled as "live." Homemade versions can be more potent and diverse but require strict hygiene practices to prevent the growth of harmful moulds or bacteria

A post-RYGB patient with serum B12 below 100 pmol/L may need eight to twelve weeks of aggressive repletion, sometimes with intramuscular injections, before I am comfortable operating