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Poor absorption of vitamin B 12 may be due to: alcoholism bowel disease, such as Crohn disease, celiac disease or a parasitic infection prior surgery that removed portions of the stomach or small intestine chronic use of medications for ulcers or heartburn such as antacids lack of a protein called "intrinsic factor" This protein is needed to absorb vitamin B 12 from the diet

A clinical trial of nicergoline to prevent temporary threshold shift

lactis Bb12 [84]

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Other factors include trauma, aging, infections, poor diet, pollution, and radiation