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You're more likely to have vitamin B12 deficiency if you have a medical condition where your body can't absorb B12 or you follow a strict vegan diet
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The ratio of Firmicutes to Bacteroidetes is a commonly-studied change with an increase often linked to HFD consumption/obesity in mice 43,44 and humans 45,46 (for review, see John and Mullin, 2016 47 )
Incidentally, the healthy reference range is 191-663 pg/ml and correlates closely with oral cobalamin intake, which is why the vitamin B12 blood level alone is not an adequate parameter to diagnose a deficiency (Herrmann and Obeid, 2014)
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