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It can be caused by a B12 deficiency

co-administration of pyridoxine has been shown to reduce the blood levels of phenobarbital and phenytoin, possibly diminishing their anticonvulsant efficacy

Abstract Diabetes mellitus encompasses a spectrum of disorders unified by hyperglycaemia but diverse in aetiology, pathophysiology and clinical expression

Some people are more likely to run low, including: Vegans and vegetarians People with digestive issues (like IBS or coeliac) Older adults Anyone on certain medications People recovering from illness We dont guess