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Conditions like pernicious anaemia (an autoimmune condition affecting a protein called intrinsic factor vital for B12 absorption), stomach issues (such as from reduced stomach acid or certain medications like proton pump inhibitors), intestinal disorders (like Crohns disease or coeliac disease), or even surgical removal of parts of the small intestine (e.g., gastric bypass surgery) can prevent proper absorption

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Whether that idea fully delivers is a more complicated story and this AOD9604 research guide tells it straight

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