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Dehydration mimics and amplifies fatigue, making it harder to distinguish B12-related tiredness from simple fluid deficit

Typically, NFGNB produce fimbriae (or attachment pili), as well as other surface adhesins, such as nonpilus or afimbrial adhesins [21]

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Decreased stomach acid Atrophic gastritis Autoimmune pernicious anaemia Helicobacter pylori Gastrectomy, partial or complete Gastric bypass surgery (weight loss) Intestinal resection Partial or complete ileectomy Gastrointestinal neoplasms Malnutrition Eating disorders anorexia bulimia Inadequate diet Vegetarianism / veganism Malabsorption syndromes Alcoholism Crohns disease Coeliac disease (gluten enteropathy) Dipphyllobothrium infection blind loop syndrome diverticulosis inflammatory bowel disease small bowel overgrowth tropical sprue gastric irradiation ileal irradiation (bladder,cervix, uterus,prostate) Inborn errors of B12 metabolism Transcobalamin II deficiency Pancreatic exocrine insufficiency & Chronic pancreatitis Imerslund Gresbeck syndrome Zollinger Ellison Syndrome Bacterial overgrowth (small bowel) Fish tapeworm Advanced liver disease Drug induced causes Please note