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Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (which can be caused by ingestion of corrosives, extensive tumors, and conditions associated with gastric atrophy, such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy) Structural lesions leading to vitamin B 12 deficiency, including regional ileitis, ileal reactions, and malignancies Competition for vitamin B 12 by intestinal parasites or bacteria

People with stomach or gut issues absorb less

Rather than focusing only on symptoms, modern medicine is beginning to focus on the systems that drive them

[12] Yamaguchi N, Sugita R, Miki A, et al