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Critical risk factors include: Pre-existing B12 deficiency, which accelerates depletion and compounds neurological damage Chronic exposure through recreational use or occupational contact, leading to severe neurological outcomes Older-adult factors, especially in those over 50, due to reduced intrinsic factor production If youre vegan, vegetarian, or taking medications like metformin or acid reducers, youll need vigilant monitoring

For more information about how BC Guidelines are developed, refer to the GPAC Handbook available at BCGuidelines.ca: GPAC Handbook