doi:10.4103/2230-8210.109667 Note: Originally published in April 2017, this article has been revised and updated for accuracy and thoroughness.
Tiredness, stress, ill-health, poor or limited diet will all reduce this absorption further. For some people, taking a vitamin B12 supplement is one of the easiest ways to maintain healthy levels

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Ketogenic diet modifies the gut microbiota in a murine model of autism spectrum disorder
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Morrison PW, Khutoryanskiy VV