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Malabsorption of vitamin B12, resulting from structural or functional damage to the stomach, where intrinsic factor is secreted or to the ileum, where intrinsic factor facilitates vitamin B12 absorption

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(3) But many dont respond due to the persistence of the bacteria, which can take the form of spirochetes and cysts, or can hide in biofilms, which are mucosal barriers that the bacteria can live in to evade the antibiotics