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One challenge I often see is that people begin to dread bedtime because they anticipate another difficult night of sleep, says Kupper

Many multivitamin preparations contain B12, though doses are typically lower (6-25 mcg) and may be insufficient for patients with absorption issues

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These dont have to be taken as frequently as oral supplements too

When the sacroiliac joints or hip joints are affected, the pelvic floor muscles can become dysfunctional resulting in pelvic pain, and/or urinary, bowel and/or sexual dysfunction