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Acquired causes of B12 deficiency can be 1) dietary, especially in vegetarian and vegan populations, 2) autoimmune, as seen in pernicious anaemia, where there is destruction of IF-producing parietal cells mediated by autoantibodies, 3) iatrogenic secondary to disruption of the acid-base status of the stomach (e.g., with proton pump inhibitor use or metformin), and 4) caused by malfunction of the terminal ileum (e.g., inflammatory bowel diseases like Crohns disease, gastric bypass or surgical resection)