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These include a vegetarian or vegan diet without reliable supplementation, older age, prior stomach or intestinal surgery, inflammatory bowel disease, celiac disease, and conditions that affect stomach acid or intrinsic factor, a protein needed for B12 absorption

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Options for vitamin B12 treatment include: Depending on the cause of the deficiency, you may only need treatment until your vitamin B12 levels are back to normal, or you may need B12 therapy for the rest of your life