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There are also certain drugs and health conditions that can increase the likelihood of developing a B12 deficiency such as: alcohol abuse, antacid use, smoking, celiac disease, other digestive concerns, pregnancy, a strict vegetarian or vegan diet, and even natural aging

In those patients, addressing the underlying metabolic dysfunction first, through dietary intervention, GLP-1 therapy if indicated, or NAD+ support for cellular energy metabolism, is the clinical priority

It is also used as an antidote to cyanide poisoning