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With long-term use, corticosteroids can result in many side effects, including a need for increased doses to manage physical stress, steroid withdrawal syndrome, insomnia, mood changes, elevated blood pressure or blood sugar levels, infections, gastrointestinal symptoms, increased appetite and subsequent weight gain, osteoporosis, cataracts or glaucoma in the eyes, hardening of the arteries or avascular necrosis

Cooke, M.E., et al

It could also mean transcobalamin is not functioning correctly

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