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The primary limitation relates to the modest sample size and short intervention duration, which may limit precision and long-term inference but does not substantially undermine internal validity under JBI criteria
The report covers gut microbiome diversity, markers of gut-driven inflammation, indicators of leaky gut, levels of keystone bacteria, including Akkermansia and Bifidobacterium and signals related to metabolic and immune function
Academy of Nutrition and Dietetics
According to NHS guidance, neurological symptoms can occur even without anaemia, and the severity of symptoms does not always correlate with B12 levels
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