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However, reduced dietary intake due to appetite suppression and gastrointestinal side effects may indirectly increase deficiency risk, particularly if consumption of B12-rich animal products decreases significantly

Common reasons include: Pernicious anemia , an autoimmune condition affecting intrinsic factor production Gastrointestinal disorders, such as Crohns disease or celiac disease Prolonged use of certain medications, like proton pump inhibitors Knowing these causes helps spot at-risk people

If low or low-normal, switch to high-dose b12 supplementation separate from multivitamin (1000 to 2000 mcg daily oral or regular injections)

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