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Diet Vitamin B12 can only be found in animal foods, so vegans and vegetarians are particularly at risk (studies show that 50% of long term vegetarians, and 80% of vegans could be deficient) Alcohol and medications such as PPIs, acid suppressors, and Metformin are also risks for deficiency Poor digestion, including

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Researchers might explore this combination in models of severe metabolic dysfunction where both NAD+ depletion and poor mitochondrial health are present