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Medical Conditions, Surgeries, and Medications Lack of intrinsic factor (a protein made in the stomach thats needed for B12 absorption) - this condition is called pernicious anemia Thyroid disease HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) Autoimmune diseases like type 1 diabetes, where the immune system in the body attacks its own tissues Gastric bypass surgery (weight loss surgery) Chronic gastritis surgery Certain medications like heartburn drugs (proton pump inhibitors) which reduce stomach acid production Who Is At Risk of Vitamin B12 Deficiency

Algal Blooms Most common in the spring and summer time, algal blooms are the rapid growth or accumulation of microscopic algae and cyanobacteria (which produce cyanotoxins , some which can be very toxic) in freshwater or saltwater sources

Also included are medical equipment, such as wheelchairs, hospital beds, and oxygen equipment

Ice crystal formation can damage the peptide structure through physical disruption of molecular bonds