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No one tells us that perimenopause — the long runway toward menopause — can sometimes begin earlier than expected — most often in the forties, sometimes a little sooner in the late thirties, and usually unfolding gradually over several years before menopause, which on average arrives around age fifty-one

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Alternatively, the diagnostic criteria used to identify inadequate B12 status have been based on a known relationship between the serum B12 biomarker and low body stores, functional impairment, or clinical signs of deficiency

Vitamin B12 is an essential vitamin that plays an important role in cell reproduction