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During adulthood, serum B12 concentrations tend to decline with age, especially in the elderly (Wahlin et al., 2002), probably arising from the gradual decrease in both gastric acidity and intrinsic factor production that occurs with aging (Asselt et al., 1998

2 Table 2 Clinical Manifestations of Vitamin B12 Deficiency Maternal vitamin B 12 deficiency during pregnancy or while breastfeeding may lead to neural tube defects, developmental delay, failure to thrive, hypotonia, ataxia, and anemia