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Autophagy is a highly dynamic, multistep process involving the degradation of cytoplasmic cargo through the lysosomal machinery 51 and serves as a protective response mechanism under oxidative stress 52

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A blood test will confirm a deficiency, with typical thresholds being total B12 levels under 180 nanograms per litre or active B12 below 25 pmol/l

The gutbrain axis, a bidirectional communication network involving the vagus nerve, enteric nervous system, and hypothalamic-pituitary-adrenal (HPA) axis, may influence cognitive and mood symptoms