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Some travelers do both destinations in a single trip

N Engl J Med 361: 455467

specific study formulations fall outside the scope of this discussion

This is often due to limited dietary intake, malabsorption, medical conditions, or the use of B12-depleting medications ( Vitamin B12 deficiency is determined as follows ( Because the ability to absorb B12 from food declines with age, deficiency is more common in older adults