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While anyone with a B12 deficiency can benefit from injections, certain groups are more likely to require this treatment, including vegetarians and vegans who may not consume enough B12-rich foods, individuals with digestive disorders like Crohns disease or coeliac disease, those with pernicious anaemia that affects B12 absorption, people recovering from weight loss surgery or other gastrointestinal procedures, older adults whose ability to absorb B12 decreases with age, and individuals experiencing prolonged fatigue or low energy levels

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This dysbiosis can drive immune activation through several mechanisms

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