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Food remains in the gastric cavity for a prolonged period, which can physically stretch the stomach wall and irritate local nerve pathways

Groups at higher risk of deficiency include older adults (due to reduced stomach acid production), vegans and vegetarians, people with pernicious anaemia or gastrointestinal disorders affecting absorption, and those taking certain medications such as metformin or proton pump inhibitors

doi:10.1210/me.2002-0070

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