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Deficiency after gastric banding is therefore primarily related to: Reduced dietary intake and food tolerance , limiting consumption of B12-rich foods Use of acid-suppressing medicines (PPIs or H2RAs) , which can impair the release of B12 from food proteins and reduce absorption of food-bound B12 Crystalline B12 the form found in supplements and fortified foods does not require acid or pepsin for release

Vitamin B12 is essential for red blood cell formation, DNA synthesis, and nervous system function, and occurs naturally almost exclusively in animal-derived foods

Vegans and "patients with diseases like Crohn's and colitis as well as people with pernicious anemia are also particularly vulnerable to deficiency," added Silverstein

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