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Vitamin B12 Deficiency Causes of vitamin B12 deficiency include difficulty absorbing vitamin B12 from food, lack of intrinsic factor (e.g., because of pernicious anemia), surgery in the gastrointestinal tract, prolonged use of certain medications (e.g., metformin or proton pump inhibitors), and dietary deficiency

Increase fiber intake gradually, drink adequate water (at least 8 glasses per day), and consider a magnesium citrate supplement if needed

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This takes more than 48 hours to break down to useable B12, and only a tiny amount is converted

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Current understanding is limited to in vitro and animal research