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It could point to several things: A different cause: your fatigue might stem from thyroid problems, iron deficiency, or sleep apnea rather than B12

Age-related changes include reduced gastric acid production (hypochlorhydria or achlorhydria), which impairs the release of B12 from food proteins

Gaba RC, Lewandowski RJ, Hickey R, et al

We found no significant difference among studied administrated routes in all other CBC parameters and homocysteine levels

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This can help to naturally supplement deficiencies and improve your symptoms