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If there is a lack of cobalamin in the body, methylmalonyl CoA accumulates, which presumably leads to the neurological manifestations of B12 deficiency.47912 The replenishment with parenteral cyanocobalamin causes a rapid and complete improvement of megaloblastic anemia and gastrointestinal symptoms caused by vitamin B12 deficiency

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Recent research has suggested that probiotics can improve intestinal function and amend intestinal leakage caused by stress in animal models and may reduce the level of cortisol in humans (208, 209)

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