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However, among patients undergoing routine hemodialysis, high TMAO levels are significantly associated with higher hospitalization rates, and patients with high plasma TMAO levels have higher hospitalization rates than those with low plasma TMAO levels (Zheng et al., 2020)

Thyroid dysfunction (both hypo- and hyperthyroidism) can cause diffuse thinning

So, while there are upper limits that people should stay below for B vitamins, its pretty unusual for anyone to reach them

Pernicious anaemia develops slowly, and its symptoms may be mild at first but worsen over time

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