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Rapid weight loss and a decreased appetite can sometimes lead to nutritional deficiencies, such as low vitamin B12 or iron, and cause worsening numbness, weakness, hair loss, or vision trouble

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Untreated, BH4 deficiency with high phenylalanine can lead to developmental delays, muscle dysfunction, cognitive impairment, and sometimes epilepsy.[ref] Rare mutations in different genes in the BH4 pathway can cause different genetic conditions

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