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One common reason behind this could be poor absorption, said Dr Manjusha Agarwal, senior consultant, internal medicine, Gleneagles Hospital Parel Mumbai, adding that conditions like anaemia, celiac disease, Crohns disease, or even long-term use of medications can affect how the body absorbs B12 from the digestive tract. Moreover, Dr Agarwal said that as people age, their stomachs produce less acid, which is necessary to release B12 from food.