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Serious side effects, while rare, include pancreatitis, gallbladder issues, hypoglycemia, dehydration, and in extreme cases organ dysfunction—especially when misused or combined with unregulated compounds

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severe thiamine deficiency, while rare, can cause Wernicke’s encephalopathy in hyperemesis gravidarum, and inadequate B₆ is associated with anemia and neurologic issues in the newborn

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