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"Adult-onset CblC deficiency: a challenging diagnosis involving different adult clinical specialists"

Strict vegan diets lacking fortified foods provide insufficient B12, as the vitamin occurs naturally only in animal products

When inadequate carbohydrates are ingested, the decrease in portal vein insulin concentration leads to a reduction in IGF-1 synthesis by the liver [129, 131]

For this reason, patients with Parkinsons disease on levodopa therapy should avoid high B intake unless they are also taking carbidopa (which prevents this interaction)