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[2] It is the main and most common cause of vitamin B 12 deficiency anemia in developed countries, [3] and is characterized by a triad of symptoms: [2] Anemia with bone marrow promegaloblastosis (megaloblastic anemia)

As it is not naturally present in fruit, vegetables, and grains, vegans may not get sufficient amounts of vitamin B12 in their diet

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1994 May;59(5 Suppl):1213S-1222S