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Deficiency causes megaloblastic anemia abnormally large, dysfunctional red cells that impair oxygen delivery, producing fatigue, shortness of breath, and pallor

Specifically, visceral fat cells and brown fat cells are richer in -adrenergic receptors and hormone-sensitive lipase, while subcutaneous white fat cells tend toward higher acetyl-CoA carboxylase expression

A secondary passive diffusion pathway allows approximately 1% of ingested B12 to be absorbed directly across the intestinal mucosa, independent of intrinsic factor

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