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Since decreased Parasutterella relative abundance may accompany increased stress 80,81 , the increased Parasutterella relative abundance that occurred in this study following diet switch likely arose from the weight loss-mediated negative energy state

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Even with oral supplementation, deficiencies may persist due to reduced intrinsic factor or altered digestion

Regular follow-up appointments allow for progress monitoring and adjustments as necessary

I never got diagnosed because it was too late and my health deteriorated fast