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For this reason, some authors prefer to be conservative in terms of not overestimating absorption and to consider that not all foods have the same absorption rate, since the richer the food is in B12, the less will be absorbed

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Neurological manifestations are particularly concerning and may include peripheral neuropathy with paresthesias (tingling and numbness in hands and feet), ataxia, impaired proprioception and vibratory sense, cognitive impairment, memory loss, and in severe cases, subacute combined degeneration of the spinal cord