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B12 deficiency on its own leads to memory loss, cognitive decline, depression, constipation, diarrhea, nerve damage / numbness, sore tongue, insomnia, fatigue, abdominal discomfort, easy bruising / anemia, and and memory problems

Many older Americans, however, have low blood levels of vitamin B6, which may suggest a marginal or sub-optimal vitamin B6 nutritional status

In this regard, the lack of purity and the same microbial strength in the prescribed supplements has made it difficult to generalize the results of the studies

Response: We thank the commenters for their perspectives on packaging within the OPPS, including specific examples of cost exceeding offset amounts