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due to ageing or through acid-lowering medication), or bariatric surgery, lack of pancreatic enzymes, small intestinal bacterial overgrowth, certain intestinal parasites or dysfunction of the small intestine (e.g
There are other reasons such as iron deficiency and thyroid dysfunction that may lead to symptoms similar to sub-optimal B12 levels
[41] : 975 Children diagnosed with low serum B 12 can be treated with intramuscular injections, then transitioned to an oral dietary supplement
Calzada Limited Annual Report (2008)
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