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People at highest risk include those with pernicious anaemia, strict vegans and vegetarians, individuals over 60, patients with gastrointestinal disorders (Crohn's disease, coeliac disease), those who have had gastric or bariatric surgery, and long-term users of metformin or proton pump inhibitors

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Fish and shellfish: Fish such as salmon, trout, and haddock, as well as shellfish such as clams and mussels, are all rich in vitamin B12