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Disruptions in the intrinsic factor (IF) pathway, including impaired IF production due to autoimmune conditions (pernicious anemia), damage to the ileum from diseases like Crohn’s or celiac disease, or surgical resection of the ileum, can severely impair B12 absorption

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People with Wernicke-Korsakoff syndrome and those who are withdrawing from alcohol may receive thiamin injections to help them recover