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La disfuncin neuronal que caracteriza a la diabetes16, la hiperglucemia, las modificaciones dietticas, entre ellas el uso de edulcorantes, e incluso la mayor predisposicin a ciertos trastornos psicolgicos16 son algunos de los factores que pueden contribuir de manera independiente o interactuar en conjunto para el desarrollo y progresin de sntomas gastrointestinales en este grupo de pacientes psicolgicos16,17

According to the NIH Office of Dietary Supplements, functional B12 deficiency is most commonly seen in patients with one or more of the following: Age over 50 stomach acid production declines with age, and stomach acid is required to free B12 from food PPI or H2 blocker use reflux medications suppress the acid needed for B12 absorption Metformin use, which interferes with B12 absorption directly Vegan or vegetarian diets B12 is found almost exclusively in animal products Gut conditions including celiac, IBS, SIBO, and Crohns MTHFR mutations that affect how B12 is metabolized once absorbed Heavy alcohol use The symptoms of low B12 are easy to dismiss: fatigue, brain fog, low mood, tingling in the hands or feet, weakness, and shortness of breath on mild exertion

Used in laboratory models of myocyte and cell-culture growth

Eat smaller, more frequent meals four or five smaller meals beats three big ones Eat slowly, chew thoroughly, put your fork down between bites Stop when you're satisfied, not stuffed eating past comfortable fullness is the fastest route to nausea Stay hydrated aim for at least 64 oz of water a day, sipped throughout the day Don't lie down for at least 30 minutes after eating

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