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According to the NIH Office of Dietary Supplements, B12 is essential for red blood cell formation, neurological function, and DNA synthesis

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Without adequate intake of B12, vegans can easily develop deficiency over time, leading to symptoms such as fatigue, weakness, constipation, loss of appetite, weight loss, and nerve problems therefore the researchers recommend that vegans and vegetarians should add vitamin B12 to their diet by eating fermented foods, particular types of mushroom that contain the vitamin and B12-enriched vegetables

Injections may be recommended for individuals who have difficulty maintaining healthy B12 levels through diet or oral supplements