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Focusing on the nervous system, several studies highlight how metabolic alterations due to VitB12 deficiency can trigger molecular/cellular changes, such as the accumulation of oxidative stress, epigenetic modifications, modulation of gene expression or protein content, or alterations in lysosomal activity

Etiology Insufficient dietary intake [1] Vegan diet: Vitamin B 12 deficiency typically only develops after years of strictly avoiding all animal products (unlike folate deficiency, which occurs within a few months of insufficient intake)