Patient was educated on the causes of vitamin B12 deficiency as follows:

  1. Vegan lifestyle
  • Vitamin B12 is mainly present in organ meat, muscle meat, and milk & animal products.
  • Individuals that are strictly vegans have very limited sources of vitamin B12 and so, can be at increased risk for deficiency.
  1. Injury to small intestine
  • Vitamin B12 is normally absorbed in the small intestine.
  • Any injury to small intestine, such as, in individuals with Crohn’s disease or celiac disease, can result in poor B12 absorption.
  • Individuals with history of small intestine resection can have reduced site of B12 absorption, contributing to compromised B12 absorption and deficiency.
  1. Medications
  • Chronic use of some antiseizure, antibiotic, and anti-inflammatory medications can interfere and inhibit absorption of B12 in small intestine.
  • Individuals taking antacid and anti-GERD medications can have the acid environment in the stomach needed for B12 absorption compromised, contributing to reduced B12 absorption.
  • Reduced absorption can result in B12 deficiency.