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[39] The elderly are at increased risk because they tend to produce less stomach acid as they age, a condition known as achlorhydria, thereby increasing their probability of B 12 deficiency due to reduced absorption

In severe cases of B12 deficiency, macrocytic anemia typically shows hypercellular bone marrow and ineffective erythropoiesis, where immature red blood cells die off before they can enter the bloodstream [1]

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