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Some 50,000 deaths can be attributed to malnutrition in Germany each year, according to the German Society for Nutritional Medicine (DGEM). The problem is that malnutrition often doesn't become apparent until the consequences are already severe. "In most cases, you don't notice anything at first," said Matthias Pirlich, a nutritional expert and internal medicine specialist, who once served as DGEM vice president. "You could have a severe vitamin D deficiency for months before any symptoms appear at all. The same applies for vitamin B12. By the time symptoms appear, such as nerve damage, it's already too late." A long-term B12 deficiency can damage the spinal cord, leading to numbness in the limbs, muscle weakness or even paralysis.
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