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Having an autoimmune disease : Some autoimmune diseases can damage the stomach lining (including pernicious anemia) where intrinsic factor is produced

What the Authoritative Sources Say About B12 Deficiency and Supplementation The National Institutes of Health Office of Dietary Supplements publishes the most thorough citation-backed overview of vitamin B12 its role in red blood cell formation and neurological function, the populations most at risk for deficiency (older adults, people on long-term metformin or proton pump inhibitors, vegetarians and vegans, people who have had gastric bypass surgery), and the recommended daily intake at each life stage

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