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Deficiency is common in those with fatigue, brain fog, or nutrient absorption issues, especially individuals with gastrointestinal conditions, vegans and vegetarians, or those taking medications like metformin or proton-pump inhibitors

These effects may be connected to modulation of growth hormone and IGF-1 signaling, as well as alterations in hepatic urea cycle enzyme activity

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26 Only two of the reviewed studies were RCTs of B12 on its own in children with ASD, both using subcutaneous methyl-B12

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