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Common reasons a prescriber orders it include: Pernicious anemia , an autoimmune condition in which the stomach stops making intrinsic factor, so B12 cannot be absorbed from food Malabsorption , Crohn's disease, celiac disease, small bowel resection, or other gastrointestinal conditions After bariatric surgery , gastric bypass and similar procedures reduce the cells that make stomach acid and intrinsic factor Medication-associated deficiency , long-term metformin, proton pump inhibitors, or H2 blockers can interfere with B12 absorption Vegan and strict vegetarian diets , natural food sources of B12 are essentially limited to animal foods Some neurologic situations , when a prescriber is treating or preventing the nerve damage that B12 deficiency can cause What the evidence does and does not support
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[DOI] [PubMed] [Google Scholar] 63.Sullivan J.M., Traynelis S.F., Chen H.S., Escobar W., Heinemann S.F., Lipton S.A