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You may be more likely to develop a B12 deficiency if you: Follow a vegan or vegetarian diet (B12 is mostly found in animal products) Have digestive issues like gastritis, Crohns disease, or celiac disease Take medications like metformin (for diabetes) or proton pump inhibitors (for acid reflux) Are over the age of 50 Have undergone gastrointestinal surgery (e.g., bariatric surgery) Suffer from autoimmune disorders such as pernicious anemia If any of these apply to you and your skin is acting upread on