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Other causes include strict vegan diets, malabsorption disorders (coeliac disease, Crohn's disease), gastrointestinal surgery, and long-term use of medications such as metformin or proton pump inhibitors

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Identity by mass spec is straightforward, but copper content needs to be quantified too, and a clean batch will have both

You cannot meaningfully overdose on oral vitamin B12 in the way you can with fat-soluble vitamins like vitamin A