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The only reason Mayo would publish this description of B12 deficiency is that misunderstanding among physicians of B12 deficiency and its treatment is so widespread

Mitochondrial Influence: May affect oxidative-phosphorylation efficiency or substrate preference in cellular metabolism

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The exact cause is not fully understood, but it involves the following factors: Genetic factors : Individuals with a family history of coeliac disease are at a higher risk of developing the condition

Pain level is mild to moderate discomfort

While technically you could get too much vitamin B in your diet, its rare