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People who have gastrointestinal disorders like celiac disease or Crohn's disease or who have undergone weight-loss surgery may secrete too little hydrochloric acid or intrinsic factor

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Some people who suffer from dementia or other forms of mental or mood disturbances have also shown improvements after receiving vitamin B12 injections

But, if either substances are pushed too quickly the resulting damage to the tissue can cause a nasty charley horse like pain that can persist for hours or days