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Common causes include liver disease (which releases stored B12), kidney disease (reducing B12 clearance), haematological malignancies, solid tumours, and excessive supplementation

However, this coupling between the circadian clock and inflammation has been suggested to be reciprocal, with also the circadian clock subjected to inflammation-driven reprogramming

Unfortunately, I, like many with autoimmune disease, had a sub-optimal start to my microbiome, which faced several challenges that reduced its quality

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doi:10.1016/S0021-9258(18)53699-1