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Animal-model evidence consistently shows local effects: angiogenesis at the injury site (VEGF upregulation), growth-factor signaling (EGF, FGF), nitric oxide pathway modulation, and accelerated tendon-to-bone interface healing in rat Achilles transection studies

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While some trials suggest a connection, more peer review is required to confirm whether oral vitamin B12 supplements or intramuscular injections can prevent fractures

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