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Patients receiving long-term therapy with omeprazole or other proton pump inhibitors (PPIs) should be monitored for signs of B12deficiency

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Those who follow a vegetarian or vegan diet may have trouble getting enough B12 from food alone

By the way, even if you dont have pernicious anemia, but a severe B12 deficiency due to other causes, B12 shots are still the way to go

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Preclinical studies demonstrate elevated intracellular NAD+ levels following NNMT inhibition, suggesting a role in metabolic energy regulation