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Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (ingestion of corrosives, extensive neoplasia), and a number of conditions associated with a variable degree of gastric atrophy (such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy)

Monitoring includes checking for contaminants that could lead to fouling or biological growths like algae or bacteria within the system

Patients who expect dramatic body composition changes will be disappointed