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[36] Vitamin B 12 deficiency is most commonly caused by malabsorption, but can also result from low intake, immune gastritis, low presence of binding proteins, or use of certain medications

If digestive symptoms or poor absorption are suspected, treatment of the underlying issue may matter more than increasing the dose, and some people may need assessment through endoscopy depending on the cause

But we often do not get from eating naturally or from supplements because much was destroyed in the gut

Your heart may feel like its fluttering and pounding several times an hour or day and can come and go over the course of several weeks or months