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Several other medical conditions frequently mistaken for B12 deficiency include: Chronic fatigue syndrome Fibromyalgia Dementia and Alzheimer's disease Depression and bipolar disorder Functional neurological disorder Age-related concerns often mask B12 deficiency symptoms

[9] Certain medications interfere with B12 absorption, most notably metformin (used for type 2 diabetes), proton pump inhibitors (PPIs), and H2-receptor antagonists when used long-term, as they reduce stomach acid production necessary for B12 release from food proteins