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Medical Conditions, Surgeries, and Medications Lack of intrinsic factor (a protein made in the stomach that’s needed for B12 absorption) - this condition is called pernicious anemia Thyroid disease HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) Autoimmune diseases like type 1 diabetes, where the immune system in the body attacks its own tissues Gastric bypass surgery (weight loss surgery) Chronic gastritis surgery Certain medications like heartburn drugs (proton pump inhibitors) which reduce stomach acid production Who Is At Risk of Vitamin B12 Deficiency