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ADVERSE REACTIONS: Occasional deaths have occurred in piglets following the administration of parenteral iron dextran preparations

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Levels naturally decline with age, chronic illness, and prolonged oxidative stress

(PubMed) Clarke R, Smith AD, Jobst KA, Refsum H, Sutton L, Ueland PM

As B12 only occurs in animal foods or fortified foods, oral supplementation of B12 and allied B vitamins should be a standard of care for those following a plant based or highly restrictive diet, as well as those over 60 with reduced capability for nutrient absorption