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This is often due to limited dietary intake, malabsorption, medical conditions, or the use of B12-depleting medications ( Vitamin B12 deficiency is determined as follows ( Because the ability to absorb B12 from food declines with age, deficiency is more common in older adults

doi.org/10.1016/j.molmed.2005.07.004 Crockford, D., et al

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Dig.Dis Sci 2006;51(12):2242-2247