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Additionally, vitamin B 12 deficiency can also occur as a result of other malabsorptive conditions (such as inflammatory bowel disease, or pancreatic insufficiency), after certain procedures (such as bariatric surgery, or ileal resection), restricted diets (such as veganism), or the use of certain medications (such as metformin or proton-pump inhibitors)

doi: 10.1002/jbmr.3686

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NMDA receptors, when overactive, contribute to excitotoxicity and excessive neural firing