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For example, people who have pernicious anemia, a condition in which they cannot make intrinsic factor which is needed for B12 absorption are not able to use vitamin B12 from foods or dietary supplements

The underlying condition is sequenced first per ICD-10-CM guidelines

This interacts with the HPA axis your body's central stress-response system in a straightforward way: when you're physically exhausted and neurologically compromised, cortisol stays elevated longer, recovery from stressful events takes more time, and the subjective experience of stress intensifies

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