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Vitamin B12 Deficiencies Vitamin B12 is necessary for patients with a low serum level of vitamin B12 because they take particular medications or because they suffer from: Pernicious anemia Gastrointestinal or autoimmune disorders Alcoholism Patients may also have low levels of vitamin B12 if they have had bariatric surgery, are strict vegetarians, or have used antacids or proton pump inhibitors for a prolonged period

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