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When deficiency is suspected based on clinical features (fatigue, paraesthesia, cognitive changes) or risk factors (vegan diet, gastric surgery, certain medications), serum B12 measurement guides appropriate intervention

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(The label also mentions that adults using Adderall have reported serious cardiac problems, though the role of the drug in those cases is unknown.) Yet college students tend to consider Adderall and Ritalin benign, in part because they are likely to know peers who have taken the drugs since childhood for A.D.H.D

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