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That's why the Office of Dietary Supplements states that people over 50 should gain most of their B12 from dietary supplements or fortified foods

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However, if pain persists for weeks or worsens, it may indicate a vaccine-related injury such as Shoulder Injury Related to Vaccine Administration (SIRVA)

Proton pump inhibitors reduce gastric acid production, which impairs the release of food-bound B12 but has less effect on synthetic B12 in supplements

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