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A decrease in SCFA-producing bacteria, especially butyrate producers like Faecalibacterium and Roseburia from the Firmicutes phylum , along with certain Bacteroides species, has been observed in ME/CFS patients [10, 25, 28]
In my own practice, especially if an older person has risk factors for vitamin B12 deficiency, I consider a vitamin B12 level of 200-400 pg/mL borderline, and I usually order a methylmalonic acid level as a follow-up
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