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Common causes include: Pernicious anemia, an autoimmune disorder hindering Vitamin B12 absorption Gastrointestinal surgeries, like gastrectomy, impact Vitamin B12 uptake Long-term use of certain medications, such as metformin or proton pump inhibitors Diets lacking in Vitamin B12, often seen in vegans and vegetarians For those without a deficiency, Vitamin B12 injections are not typically recommended, as their body can naturally regulate and excrete excess amounts of the vitamin

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They also considered the question of whether acid-suppressing drugs such as omeprazole or esomeprazole affect vitamin B12 levels ( American Journal of Clinical Nutrition , June 16, 2021}

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