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Aging athletes, especially those over the age of 60, are also at risk for deficiency with age-related atrophic gastritis, low stomach acid, and an inadequate amount of a certain protein needed to absorb B12 (intrinsic factor)

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The multi-faceted ecto-enzyme CD38: roles in immunomodulation, cancer, aging, and metabolic diseases

Approximately one year later, he experienced a severe worsening of his previously very mild neuropathy, and lab evaluation yielded a serum B12 of 220 pmol/l (which is normal, remember!?), but an elevated serum MMA of 1300 nmol/l, supporting the existence of true B12 deficiency