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Pancreatic Insufficiency: The pancreas helps with B12 absorption, and not enough of it can cause deficiency

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Journal of Regenerative Medicine , 8(2), 134142

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Or as Miller puts it, Youve essentially made the person equivalent of having pernicious anemia. Thats because these surgeries can reduce the production of both intrinsic factor and stomach acid, which is necessary for digesting food

DISCUSSION We demonstrated that well-placed arcade vessels respond poorly to the increased demands that occur upon blood supply deprivation, reperfusion or additional bowel obstruction