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Its mostly found in animal-based foods, so if your diet is limited or your body struggles to absorb nutrients , your B12 levels can drop

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Foster CC, Kochanny S, and Khattri A, et al (2018) Association of immune-related adverse events (irAEs) with improved response, progression-free survival, and overall survival for patients with metastatic head and neck cancer receiving anti-PD-1 therapy J Clin Oncol 36 (15_suppl) 6014 68

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