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A small number of users may experience gastrointestinal effects so severe that they need to stop taking the medication

When the gut environment is disrupted, the abundance of specific beneficial microorganisms decreases, and the abundance of pathogenic bacteria may increase, a phenomenon known as gut dysbiosis

13 Another study, comparing oral and sublingual administration of a complex of B12, folate and vitamin B6 also found no significant differences in effect on homocysteine between the two modes of administration

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Ueno A, Hamano T, Enomoto S, et al