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[10] Long-term use of proton pump inhibitors (PPIs) and H2-receptor antagonists reduces gastric acid, potentially impairing the release of B12 from dietary proteins

Common explanations include: Viral illnesses, such as dengue or influenza Certain drugs Vitamin deficiency Bone marrow diseases Another common issue is why platelet counts are decreasing, which could be due to the body destroying platelets faster than they are produced