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Studies treating mild to moderate B12 deficiency in older people have failed to provide cognitive benefits: A clinical trial from the Netherlands measured the cognitive response to B12 supplements in people 70 years old with mild B12 deficiency and MMA levels 320 nmol/l (average: ~450 nmol/l)
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In conditions like chronic inflammation or cancer, the altered activity of the PPP can significantly affect macrophage function, either promoting or suppressing inflammation (He et al., 2021
It is a systemic inflammatory condition
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