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found that high-altitude residents whose family history spans several millennia of long-term residence at high altitude develop higher defenses than those who descend from populations with only multiple or single generations of residence 9

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Patients taking certain medications (e.g., chloramphenicol may reduce the effectiveness of B12 therapy) or with risk factors for B12 deficiency (metformin use, proton pump inhibitors, nitrous oxide exposure, vegan diet) should discuss these with their healthcare provider

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I mean anyone that drives a car, you're at risk to some degree, right