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116,117 In the early stages of tumor development, the immune microenvironment mainly suppresses tumor proliferation through the cytokine environment produced by activated CD8+ and CD4+ T cells

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Certain populations face higher deficiency risk: vegetarians and vegans (B12 is primarily found in animal products), adults over 50 (decreased stomach acid reduces B12 absorption), individuals with digestive disorders like Crohn's disease or celiac disease, and those taking medications like metformin or proton pump inhibitors