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Liver, spleen, and pancreas are often affected

But he added: The B12 specific issues are more surprising

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Updated statistics of lung and bronchus cancer in United States (2018)

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Absorption problems Even with adequate intake, absorption can be reduced by: Certain gastrointestinal conditions affecting the stomach or small intestine Some medications Age-related reduction in stomach acid (which can affect absorption) Autoimmune gastritis (often historically referred to as pernicious anaemia) This is a well-recognised cause of B12 deficiency and may require ongoing management