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Things like aging, certain health conditions, or even some medications can make it difficult for your body to use the B12 from your food

Indeed, in an older clinical trial, supplementation with 2 - 4 grams of L-tryptophan daily was as effective at preventing migraine attacks as the medication methysergide (Sicuteri 1973)

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Both lower B12, but the cause and clinical evaluation differ, so a provider distinguishes them with antibody and blood testing