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doi: 10.1001/jama.282.16.1530

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[5] [6] However, it is important to emphasise that not all mouth ulcers are caused by B12 deficiency , and other factors such as immune dysfunction, genetic predisposition, and local trauma also play important roles

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You also need certain digestive factors, including adequate amounts of acid in your stomach and a substance called intrinsic factor, in order to absorb vitamin B12 from the food you eat