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There are no efficacy trials

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[DOI] [PubMed] [Google Scholar] 43.Afaghi A, O'Connor H, Chow C: Acute effects of the very low carbohydrate diet on sleep indices

RI Kirk contributed to preparation and management of the clinical trial

Nutritional imbalances, including low B12 levels, are becoming increasingly common due to: Highly processed diets Use of acid-reducing medications Digestive disorders (like IBS or celiac disease) Vegetarian or vegan diets without proper supplementation In suburban communities like Troy, MI, where fast-paced lifestyles often limit dietary variety, its easy to overlook vitamin levels until symptoms appear