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Individuals may also experience tingling or numbness in their hands and feet due to nerve damage

Absorption can also be inhibited by poorly functioning kidneys, cigarette smoke, nitrous oxide used for anaesthesia, heating food in a microwave or cooker and some medications, including Metformin (for diabetes), anticonvulsants and proton pump inhibitors (PPIs)

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Emerging research suggests that vitamin B12 may not only influence neurodevelopment directly through its roles in DNA methylation and neuronal integrity but also indirectly via its modulation of the gut microbiota [60,65,68]