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Not having enough of it is common, especially for people who dont eat meat, like vegetarians or vegans

Iron Replacement in the Setting of Polycythemia It may seem counterintuitive to give iron to someone with elevated hematocrit, but studies confirm that iron repletion is safe and necessary in patients with secondary polycythemia who are iron deficient (Lui et al., 2017

This means the appetite suppression does not continue to increase proportionally with dose beyond a certain point

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