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Other conditions that make Vitamin B12 absorption more difficult are: Weight loss surgery or another operation that removed part of your stomach Heavy drinking Taking acid-reducing medication for a long time Certain health issues may also lead to the development of vitamin B12 deficiency such as atrophic gastritis, pernicious anemia, Crohns disease, celiac disease, immune system disorders, Graves disease and lupus

This is not a diffuse, whole-brain effect