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First, aging can change a persons gut [gastrointestinal (GI) system] over time, and the changes can make it more difficult for food to release B12 into the body or for the body to absorb it, Dr

However, after surgical removal of the ovaries, the production of these hormones stops completely, which can contribute to additional symptoms like decreased sex drive and fatigue

While the normal range is typically between 138-652pmol/L, the reality is that many patients feel better if B12 levels are in the higher end of that range