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Reduced secretion of gastric acid and pepsin, from the use of H 2 blocker or proton-pump inhibitor (PPI) drugs, can reduce the absorption of protein-bound (dietary) vitamin B 12 , although not of supplemental vitamin B 12

Vitamin B12 plays a vital role in red blood cell production, neurological health, and DNA synthesis

Medications: Long-term use of antacids and metformin can impact B12 absorption

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BPI can be preganglionic or postganglionic, and the level of injury determines the appropriate treatment method or prognosis 3