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CAUSES OF B12 DEFICIENCY Atrophic gastritis, in which your stomach lining has thinned Pernicious anemia, which makes it hard for your body to absorb vitamin B12 Conditions that affect your small intestine, such as Crohn's disease, celiac disease, bacterial growth, or a parasite Immune system disorders, such as Graves' disease or lupus Been taking certain medications that interfere with the absorption of B12

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Regarding the hemoglobin level, the pooled effect sizes showed no difference between all routes of administration that could reach statistical significance