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The probable etiologies for the vitamin B 12 deficiencies in the patients without a history of gastrectomy were gastritis, diabetes medications, a vegetarian diet, antibodies to the intrinsic factor, and early gastric cancer
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However, while data suggests this amount of cyanide is not a problem for most people, some researchers suggest that people with kidney impairment may have difficulty removing it from the body easily and cyanide can build up