Etiology
Deficiency may be due to:
- Defective vitamin B12 absorption, e.g. in pernicious anemia or certain drug therapies that cause low intrinsic factor production.
- Bacterial overgrowth of the GI tract that uses up vitamin B12 [GP2008].
- Genetic mutations in B12 transporter proteins may result in a functional intracellular deficiency of vitamin B12, despite adequate serum levels of vitamin B12 [PA-OAT], [Surendran2018 🕮 ].