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Atrophic gastritis, with resulting hypochlorhydria, is a major cause, especially in the elderly

Once ingested, Vitamin B12 is absorbed in the small intestine with the help of intrinsic factors

Glucose Metabolism: Growth hormone is known to impair glucose tolerance and insulin sensitivity, sometimes precipitating diabetes or worsening glycemic control in diabetic patients

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doi: 10.1093/oxfordjournals.aje.a009814
