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People with Absorption Issues Several conditions can impair B12 absorption: Pernicious anaemia An autoimmune condition thats the most common cause of severe B12 deficiency in the UK Crohns disease or coeliac disease Previous gastric surgery Including gastric bypass Chronic use of certain medications Including proton pump inhibitors (PPIs), metformin, and some anti-seizure medications Others at Risk Pregnant and breastfeeding women (who have increased B12 requirements) Heavy alcohol consumers Those with chronic inflammation affecting gut health People taking certain oral contraceptives B12 Deficiency in the UK: How Common Is It