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Therapeutic response to cyanocobalamin may decrease due to elderly age, infection, renal insufficiency, diabetes mellitus, marrow suppressants use (e.g
The NIH Office of Dietary Supplements, citing Institute of Medicine recommendations, advises that it is advisable for those older than 50 years to meet their RDA mainly by consuming foods fortified with vitamin B12 or a supplement containing vitamin B12. This recommendation reflects the fact that 10 to 30% of older adults lose the ability to efficiently absorb naturally occurring B12 from food
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