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[DOI] [PubMed] [Google Scholar] Mathieu 2009 Mathieu S, Boutron I, Moher D, Altman DG, Ravaud P

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As such, insufficient levels of stomach acid can interfere with the absorption of B12 and can lead to a deficiency, even if dietary intake is optimal

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If symptoms are severe, seek medical attention

Protein intake matters significantly since bones and muscles require amino acids for rebuilding