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Medical supervision is crucial for several reasons

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People who eat mostly plants tend to have microbial communities that produce less TMAO from carnitine

I wouldnt count on sources like seaweed, spirulina, or soil. I hear people that likely do need to supplement with B12 say that theyre OK because they eat foods that may include B12, but they can be unreliable sources, such as sea vegetables or nutritional yeast, says Ginger Hultin, MS, RDN, CSO, a lifelong vegetarian, chair of the VNDPG, and spokesperson for the Academy

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