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It involves growing bacteria such as Propionibacterium freudenreichii under controlled environment
doi:10.1001/archinte.162.4.484
Those who follow a strict vegetarian or vegan diet without compensating with B12 fortified food for example ( vitamin B12 binds to animal proteins), or have low vitamin B12 levels due to a health condition that might affect vitamin B12 release and absorption, might have difficulty reaching their vitamin b12 requirements
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