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Long-term use of metformin, proton pump inhibitors or H2 blockers , which can reduce B12 absorption over years

B12 is essential for the methylation reactions required to produce the lipids and proteins that constitute myelin

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Vegans and vegetarians, for example, are at a higher risk of B12 deficiency because the main sources are animal products like meat, fish, and dairy

Always consult your prescribing clinician before combining supplements with your medication, and monitor energy and gastrointestinal tolerability over the first 2 to 3 weeks