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pylori bacterial infection or stomach ulcer You are over 50 You have a family history of B12 deficiency You are a vegan or vegetarian Youve had weight loss/bariatric surgery, since this surgery interferes with the release of B12 during digestion You have inflammatory bowel disease, leaky gut or other serious digestive disease You have acid reflux Youre a pregnant woman (who has increased needs for many nutrients) You take one of the following types of medications: antibiotics, anti-gout, blood pressure, birth control pills, cholesterol-lowering drugs, diabetes medications and antipsychotic drugs