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Deficiency is common in vegetarians and vegans who eat little or no products of animal origin

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(3) Johansen PB, Nowak J, Skjaerbaek C, Flyvbjerg A, Andreassen TT, Wilken M, Orskov H

In renal impairment, this axis contributes to a feedback loop driven by gut dysbiosis, systemic inflammation, oxidative stress, blood pressure dysregulations, and neurocognitive decline (Bugnicourt et al., 2013