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Additionally, it can be caused by either a lack of B12 in the diet, gastritis, pernicious anemia, digestive diseases (e.g., Crohn's disease and celiac disease), surgery on the GI tract, alcohol use disorder, transcobalamin II deficiency, or Sjgren's syndrome [9]

Knowing their treatment helps patients manage their condition and stay healthy

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Intakes of folate, vitamin B6 and B12 and risk of depression in community-dwelling older adults: the Quebec Longitudinal Study on Nutrition and Aging

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This benefits people with low stomach acid (including many people over the age of 50) or those who take acid blockers such as Pepcid or Zantac, or proton pump inhibitors such as Prevacid, or Prilosec, who are at an increased risk for B-12 deficiency