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The adverse effects associated with this compounded medication primarily reflect those observed with semaglutide, as cyanocobalamin is generally well-tolerated with minimal side effects when administered at therapeutic doses

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Carnitine may also regulate Bax/Bcl-2 signaling [132], AMPK/PGC1 signaling [133], MAPK signaling [134, 135], PI3K/Akt signaling [136] and other signaling pathways to play a protective role in the heart