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These conditions digestive conditions, such as Crohns disease and ulcerative colitis autoimmune conditions, such as celiac disease and type 1 diabetes genetic conditions, such as inherited intrinsic factor deficiency and inherited transcobalamin deficiency chronic pancreatic disease pernicious anemia vitiligo Other factors that may lead to a vitamin B12 deficiency can include drinking excessive amounts of alcohol or using certain drugs, such as some heartburn medicines and metformin

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doi: 10.1186/s13054-014-0503-3

The entire 20-ounce can will not be required