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Why does vitamin B12 cause nausea

Yes, but people with absorption issues (due to age, diet, or health conditions) may not get sufficient B12 from pills alone

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Symptoms of vitamin B12 and folate deficiency include extreme tiredness, shortness of breath, palpitations and muscle weakness

Because stomach acid is required for the release of vitamin B 12 from the proteins in food, vitamin B 12 absorption is diminished