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My triggers were tiredness, combined with not drinking/eating enough or getting stressed

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A normal balanced diet usually contains enough vitamin B12

"As conditions such as insulin resistance and cancer also typically increase with advancing age, it makes sense that elevated IGF levels in older age, may not be reflective of good health, as opposed to a higher IGF-1 in a younger person due to their health-promoting lifestyle behaviors." The researchers of the Aging Cell study highlight that the link between IGF-1 and health risks is U-shaped, implying that both high and low levels of IGF-1 may indicate unfavorable health outcomes