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There are also those who may be at a higher risk of a vitamin D deficiency that can benefit from a supplement, including older adults, overweight individuals, and those that live in the northern hemisphere

[1] If clinical suspicion is high, particularly with subacute combined degeneration, treatment should commence immediately as delays may result in irreversible damage

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So, future randomized control trial needs to address this potential confounding factor in evaluating more realized vitamin B12 effect