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The Role of Cobalamin in Multiple Sclerosis: An Update | Inflammation | Springer Nature Link

Valve irregularities: You may not notice any symptoms of valve irregularities, but they can lead to a heart murmur, which a doctor can hear by listening to the heart

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If you’re using N2O in any context, the safest move is to discuss it with a clinician—especially if you have symptoms of deficiency or a diagnosed low B12 level