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In fact, anywhere from three to 43 percent of older adults may have a vitamin B12 deficiency

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For those with chronic conditions like IBD or EPI, ongoing management of the underlying disease is necessary, and periodic B12 monitoring may be recommended to ensure levels remain adequate

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that is, if 14 patients were treated for 4 years with metformin 850 mg t.d.s., one would develop vitamin B12 deficiency