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Common Causes of B12 Deficiency Document the cause of B12 deficiency to support the specific code : Pernicious anemia Autoimmune destruction of stomach cells Gastrectomy or weight loss surgery Loss of intrinsic factor production Strict vegetarian diet Inadequate dietary intake Crohns disease or celiac disease Malabsorption in the small intestine Chronic pancreatitis Insufficient pancreatic enzymes Bacterial overgrowth in the small intestine Bacteria consume B12 Long-term metformin use Interferes with B12 absorption Neurologic Symptoms in B12 Deficiency B12 deficiency causes nerve damage

They address the root cause follicle miniaturisation and dermal papilla cell death rather than just masking symptoms

You need to supplement with a daily multivitamin as well as folic acid when you start on B12

When B12 levels are equivocal, additional testing with methylmalonic acid (MMA) and homocysteine levels can provide greater diagnostic accuracy, as both are elevated in true B12 deficiency