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Other factors that can put people at a greater risk of suffering from a vitamin B12 deficiency include those who smoke, abuse alcohol, or have been diagnosed with diabetes

[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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It should not be used in newborns increased mortality in patients with acute critical illnesses in intensive care units due to complications following open heart or abdominal surgery, multiple accidental traumas, or with acute respiratory failure