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For example, a B 12 -deficient state which causes megaloblastic anemia and which may be mistaken for classical PA may be caused by infection with the tapeworm Diphyllobothrium latum , possibly due to the parasite's competition with host for vitamin B 12

Vitamin B12 toxicity: Full list of potential side effects from injections or supplements VITAMIN B12 toxicity occurs when a person exceeds the recommended dosage of either supplements or injections

Other groups who may benefit include: Patients following gastric surgery (gastrectomy, bariatric procedures) where intrinsic factor production or absorption sites are compromised Individuals with malabsorption disorders such as Crohn's disease, coeliac disease, or chronic pancreatitis Strict vegans and vegetarians with dietary insufficiency, though oral supplementation is usually tried first Elderly patients with atrophic gastritis or reduced gastric acid production Patients on long-term metformin or proton pump inhibitors, which can impair B12 absorption [6] [8] Individuals with nitrous oxide exposure (recreational or medical), which can cause functional B12 deficiency Diagnosis typically involves serum B12 measurement, with levels below approximately 148 pmol/L (though thresholds vary between laboratories) generally indicating deficiency

People whose stomachs are unable to produce intrinsic factor generally suffer from vitamin B12 deficiency a health condition known as pernicious anemia

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