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in total, 9 genera (including the unclassified group) and 38 metabolites met these criteria (metabolites published in Sampson et al., 2021 13 )

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Signs and symptoms of vitamin B12 deficiency can include fatigue, pale skin, headaches, shortness of breath, fast heartbeat, gastrointestinal issues, mouth inflammation, paresthesias (abnormal sensations), decreased cognitive ability, depression, muscle weakness, imbalance and incoordination, vision problems, and erectile dysfunction

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However, not everyone notices immediate changes