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Read the opening answer first, then check the evidence and safety sections before acting on the recommendation

This complex process means that conditions affecting the stomach or intestines can significantly impair B12 absorption, including pernicious anaemia, atrophic gastritis, previous gastric surgery, coeliac disease, Crohn's disease, and long-term use of certain medications (such as metformin, proton pump inhibitors, and H2 antagonists)

It is a useful reminder to consider vitamin B12 deficiency in people taking metformin who have megaloblastic anaemia, neuropathy or other symptoms suggestive of deficiency