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Bacterial overgrowth of the small intestine may lead to low serum B12 concentrations and vitamin B12 deficiency because the bacteria utilize vitamin B12 for their own metabolism so B12 cannot be absorbed by the body

In the duodenum, pancreatic enzymes degrade the R-protein-B12 complexes, freeing B12 to bind with intrinsic factor (IF) , a glycoprotein produced by gastric parietal cells in the stomach lining