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People who have had gastrointestinal surgery Surgical procedures in the gastrointestinal tract, such as for weight loss or to remove all or part of the stomach, can cause a complete or partial loss of cells that secrete hydrochloric acid and cells that secrete intrinsic factor [54,55]

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Congenital transport-protein deficiencies, including transcobalamin II deficiency, are another rare cause of vitamin B 12 deficiency