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Patients with long-standing alcohol use, restrictive diets, malabsorption syndromes, or prolonged use of medications that deplete or interfere with B vitamins may particularly benefit when a deficiency is confirmed

"Optic neuropathy as a presenting feature of vitamin B-12 deficiency: A systematic review of literature and a case report"

In fact, the absorption of B12 requires that you have adequate stomach acid (among many other factors), which means that if you are taking acid blockers for reflux you are likely reducing your absorption of B12

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