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Fouch T, Claassens S, Maboeta M (2020) Aflatoxins in the soil ecosystem: An overview of its occurrence, fate, effects and future perspectives

The same applies if your elevated B12 is accompanied by abnormal results on other labs (liver enzymes, kidney markers, CBC), or by symptoms like unexplained weight loss, persistent fatigue, abdominal pain, or easy bruising

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However, indirect factors such as reduced dietary intake from decreased appetite, altered gastric emptying, and concurrent use of metformin may increase the risk of B12 deficiency in some patients