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Data analyses are reported on the intention-to-treat (ITT) and the per-protocol (PP) sample

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Studies show that vegans and vegetarians who dont take any B12 supplements have markedly lower B12 status and may be at risk of deficiency or already deficient (Gallego-Narbn et al., 2019

These include alterations in the monoaminergic system, changes in glutamatergic synaptic transmission, neuro-inflammation, alterations in the hypothalamic-pituitary-adrenocortical (HPA) axis, changes in brain-derived neurotrophic factor (BDNF), and hippocampal atrophy (Nazarali and Reynolds, 1992)

*The QD size was calculated from the equation D = (9.8127 x 107) ?3 - (1.7147 x 103) ?2 + (1.0064)