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As some people may have a difficult time absorbing B12 orally due to conditions like pernicious anemia, SIBO , or H

Additional studies, particularly prospective cohort studies, are needed to verify the causality, determine the generalizability to other countries, and elucidate the underlying mechanism.

A cohort study of T2DM patients ( n = 126) and non-T2DM ( n = 1,228) found that cognitive dysfunction in T2DM patients on metformin therapy is associated with low B12 serum levels (186)

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