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In addition, people who have pernicious anemia (a condition caused by autoimmunity to stomach cells that produce intrinsic factor), celiac disease and other illnesses of the small intestine, those who have undergone gastrointestinal surgery, and vegans/vegetarians are also at risk for vitamin B12 deficiency

Do You Need a Vitamin B12 Injection

And so, taking such substances while fasting, dehydrated, or in combination with other medications can be risky. A sudden drop in blood pressure, especially without medical supervision, can trigger serious complications, including cardiac arrest, he added