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One of the possible reasons that anaemia is much less prominent in B12 deficiency than lets say 30 years ago, is that many countries have started mandatory fortification of food with folate

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The effects of iron fortification on the gut microbiota in African children: a randomized controlled trial in Cote d'Ivoire

Though the mechanism is not clear, it is suggested that the acute reduction in blood glucose may cause these effects [33]

Also seek medical attention for symptoms of gallbladder problems, including pain in the right upper abdomen, fever, or yellowing of the skin or eyes