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Since decreased Parasutterella relative abundance may accompany increased stress 80,81 , the increased Parasutterella relative abundance that occurred in this study following diet switch likely arose from the weight loss-mediated negative energy state

Troy is used to treat anemia and Vitamin B12 deficiency

Whether this observation is solely the consequence of translocation of Parasutterella bacteria from the intestine to the EWAT or driven by more indirect mechanisms such as bacterially-produced metabolites 85 is yet to be determined

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Oral B12 (50150 g daily) may be appropriate for dietary deficiency without neurological involvement, but intramuscular hydroxocobalamin injections remain first-line treatment in the UK for patients with nerve symptoms or malabsorption conditions