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Additionally, if gut permeability is indeed increased in ME/CFS patients, microbes and antigens may be able to cross the epithelial barrier into surrounding tissue and blood, potentially crossing the BBB and altering the HPA axis (443)

To increase your B12 levels naturally, consider including the following in your diet: Meat (beef, lamb) Poultry Fish and seafood Eggs Dairy products (milk, cheese, yogurt) 2- For those avoiding animal products, certain plant-based options are fortified with Vitamin B12 and can be as good alternatives: Nutritional yeast Fortified breakfast cereals Fortified plant-based milk (like soy, almond, or oat milk)

Note that corticosteroid injections are not the same as anabolic steroids

The procedure is quick and simple