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10.1016/j.psyneuen.2021.105287 Psychoneuroendocrinology 116 GwakY

HIF-1 can upregulate the expression of transferrin receptor (TFR) and HO-1, further increasing intracellular iron levels and inducing ferroptosis in periodontal cells [118]

This is because the deficiency is interlinked with cognitive decline essentially indicating that when your body becomes deficient and lacking in vitamin B12, it can lead to shrinkage of your brain and a decline in brain function