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It can also be depleted by chronic stress, alcohol, smoking, digestive issues, cardiovascular disease, illness, and aging because stomach acid production decreases with age, reducing B12 absorption significantly

Certain medications can also hinder B12 absorption , and older adults have a higher likelihood of developing a B12 deficiency

When your stomach empties more slowly and produces less acid, B12 absorption drops

The symptoms of vitamin B12 deficiency often develop slowly and gradually strengthen over time, according to Harvard Health Publishing, though in some cases they may come on quickly

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