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In addition to the conditions mentioned above, several risk factors increase the likelihood of B12 deficiency: Smoking Alcohol abuse Endocrine-related autoimmune disorders (such as diabetes or thyroid disorders) Gastrointestinal disorders like Crohns disease History of gastric bypass surgery or other stomach-altering surgeries Optimize Your Health

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26 B12 present in food products requires gastric enzymes such as pepsin and stomach acid to detach it from protein, while supplemental forms of B12 are typically in an unbound state and do not require this process for absorption