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Increased NEFAs in cells compete with glucose for substrate oxidation, thus resulting in the inhibition of pyruvate dehydrogenase, phosphofructokinase, and hexokinase II [8]

The length of time B12 takes to work depends on your age and gut health, and how your body processes the vitamin

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8,9 Manifestations Vitamin B 12 deficiency affects multiple systems, and sequelae vary in severity from mild fatigue to severe neurologic impairment 1,2,6,10 (Table 2 4,10 )