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These conditions digestive conditions, such as Crohns disease and ulcerative colitis autoimmune conditions, such as celiac disease and type 1 diabetes genetic conditions, such as inherited intrinsic factor deficiency and inherited transcobalamin deficiency chronic pancreatic disease pernicious anemia vitiligo Other factors that may lead to a vitamin B12 deficiency can include drinking excessive amounts of alcohol or using certain drugs, such as some heartburn medicines and metformin

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This pattern warrants reassessment rather than automatic dose escalation

doi:10.1586/14789450.2014.965159

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