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In disease states such as atrophic gastritis and pancreatic insufficiency, low serum B12 concentrations arise because digestion of protein-bound B12 is compromised

Illnesses Any illness or condition that affects the digestive system can result in a B12 deficiency because the vitamin is bound to the protein molecules in your food and is released and absorbed by the body during digestion

If any of these are present, a shortage of B12 should urgently be considered as a cause

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