Conditions such as atrophic gastritis (thinning of the stomach lining), Pernicious anemia (which makes it harder for your body to absorb Vitamin B12), Intestinal diseases such as crohns disease, celiac disease, bacterial growth and immune system disorders such as Graves disease or lupus can lead to Vitamin B12 deficiency in the body
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If you fall into any of these categories, it's worth discussing B12 testing with your healthcare provider