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what your diet is like
4,5 Dietary insufficiency, pernicious anemia (i.e., an autoimmune process that reduces available intrinsic factor and subsequent absorption of vitamin B 12 1,2,6,7 ), and long-term use of metformin or acid-suppressing medications have been implicated in B 12 deficiency
This was established as an important research question to be funded as part of the James Lind Alliance priority-setting partnership with the Pernicious Anaemia Society
The timeline of injections can also impact their effectiveness
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