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They put vitamin B12 directly into the muscle

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doi:10.1002/elps.200900692 Etzioni A, Levy J, Nitzan M, Erde P, Benderly A (1984) Systemic carnitine deficiency exacerbated by a strict vegetarian diet

Emamectin benzoate and microplastics led to skeletal muscle atrophy in common carp via induced oxidative stress, mitochondrial dysfunction, and protein synthesis and degradation imbalance