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Although it seems this bidirectional connection is guided by various mechanisms, there is no definitive epidemiological evidence linking gut dysbiosis, the CNS, and the peripheral immune system (see Fig

High dose oral cobalamin may be a suitable alternative in selective cases, where intramuscular injections are not tolerated and compliance is not a problem

Its ongoing use in laboratory literature reflects research interest only and does not indicate therapeutic, cosmetic, or clinical benefit

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