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Nevertheless, studies utilizing more specific biomarkers of vitamin B 12 status, including measures of holo-transcobalamin and methylmalonic acid, have shown more consistent results and a trend towards associations between poor vitamin B 12 status and faster cognitive decline and increased risk of Alzheimers disease (82-86)

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However, the BfR recommends limiting the daily intake to a maximum of 9 g, i.e

People with severe malabsorption, pernicious anemia, or advanced deficiency may not respond adequately to oral supplements alone

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