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(Updated August 17, 2023)

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Common causes of B12 deficiency can include: Limited dietary intake (common in strict vegan or vegetarian diets) Pernicious anemia, an autoimmune condition that prevents proper B12 absorption in the stomach Gastrointestinal surgeries that remove part of the stomach or small intestine Age-related declines in stomach acid production Long-term use of certain medications, such as metformin or proton pump inhibitors, which can reduce the bodys ability to properly absorb vitamin B12

"Dietary Reference Intakes for Japanese 2010: Water-Soluble Vitamins" Journal of Nutritional Science and Vitaminology 2013(59):S67S82