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Seek medical advice if you experience: New or worsening vision problems Severe or progressive weakness Loss of coordination or balance Confusion or cognitive changes Seizures These symptoms could indicate underlying conditions requiring investigation

[12] Gastric acid-suppressing agents (proton-pump inhibitors and H-receptor antagonists) diminish dietary B12 liberation from protein complexes, a pharmacodynamic interaction that can exacerbate underlying deficiency

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Not only that, but often the form of B12 that these patients get is either cyanocobalamin or hydroxycobalamin