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Pernicious anemia is a B12 deficiency anemia caused by the lack of intrinsic factor.[ref] What causes the lack of intrinsic factor in pernicious anemia

Additionally, if there is an imbalance in the gut microbiome, it can increase the number of lipopolysaccharides and interleukins, leading to skeletal muscle insulin resistance and psychiatric and neurodegenerative diseases [4]

They also examined various biomarkers that can indicate B-12 status in individuals

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But it isnt clear whether the deficiency is related to the cancer or caused by something else