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You may also be more likely to develop vitamin B-12 deficiency if you have: Atrophic gastritis, in which your stomach lining has thinned Pernicious anaemia, which makes it hard for your body to absorb vitamin B12 Conditions that affect your small intestine, such as Crohns disease, celiac disease, bacterial growth, or a parasite Immune system disorders, such as Graves disease or lupus Been taking certain medications that interfere with the absorption of B12

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The tirzepatide peptide itself may or may not be affected