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Pernicious Anemia Pernicious anemia, an autoimmune disease that destroys stomach cells, reduces the bodys ability to produce intrinsic factor

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Moreover, alcoholics may experience reduced intestinal absorption of vitamin B 12 (2), and individuals with acquired immunodeficiency syndrome (AIDS) appear to be at increased risk of deficiency, possibly related to a failure of the IF-B 12 receptor to take up the IF-B 12 complex (3)

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As a vegan I have struggled with low energy for years

These include diet, malabsorption, and some medical conditions