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Caused most commonly by pernicious anaemia (autoimmune condition), dietary insufficiency in vegans, malabsorption disorders, or gastrointestinal surgery affecting B12 absorption

PMC 3257642

It's estimated that between 10 percent and 30 percent of people older than 50 produce too little stomach acid to release B12 from its carrier protein in foods

GLP-1 and GIP receptor agonists have a low intrinsic risk of causing hypoglycaemia when used alone, because their insulin-stimulating effects are glucose-dependent

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It depends on baseline status and goals