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Kidney Dysfunction: While the kidneys do not directly excrete vitamin B12 efficiently, impaired renal function may lead to elevated serum B12 levels by reducing the clearance of B12-binding proteins or altering their metabolism, thereby contributing to B12 accumulation 8
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As a result of underlying (hereditary) absorption disorders oral supplementation may prove insufficient to supplement the deficiency
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If switching to a plant-based diet, it usually takes years before a clinically manifest deficiency develops, especially taking the reserve capacity of the body into consideration
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