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Severe events (1.4%) included cases requiring gynecological evaluation: one case of endometrial hyperplasia, two cases of ovarian cysts requiring imaging, and several cases of menorrhagia (excessive bleeding) requiring iron supplementation or hormonal intervention

DOI: 10.1093/rheumatology/kew278 [Google Scholar] Fava R, Olsen N, Keski-Oja J, Moses H, Pincus T

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Vitamin B12 prevents megaloblastic anemia which causes fatigue and weakness