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Regarding plasma B12 - this is not the case, serum B12 often remains highly elevated (well over the normal range) even while symptoms return - this is why testing B12 once treatment begins is not recommended

Timeline: taking PPIs for two or more years significantly increases deficiency risk

Brain Sci 13:272 Santos-Garca D, Macas M, Llaneza M, Grande M, De La Fuente-Fernndez R (2011) Serum vitamin B 12 and folate levels in Parkinsons disease patients treated with duodenal levodopa infusion

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