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Auto immunity - Anti parietal cell antibodies or anti intrinsic factor antibodies or both Rare conditions - Hypochlorhydria - B12 does not become free from salivary binder requiring low pH, malabsorption (Crohn’s disease, celiac disease) and genetic deficiency of transporter-transcobalmin II Problem The proportion of humans adopting a plant-based lifestyle is on the rise worldwide

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In contrast, gastric sleeve surgery involves removing a large portion of the stomach, leaving a narrow, sleeve-like stomach