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Common Causes of B12 Deficiency Document the cause of B12 deficiency to support the specific code : Pernicious anemia – Autoimmune destruction of stomach cells Gastrectomy or weight loss surgery – Loss of intrinsic factor production Strict vegetarian diet – Inadequate dietary intake Crohn’s disease or celiac disease – Malabsorption in the small intestine Chronic pancreatitis – Insufficient pancreatic enzymes Bacterial overgrowth in the small intestine – Bacteria consume B12 Long-term metformin use – Interferes with B12 absorption Neurologic Symptoms in B12 Deficiency B12 deficiency causes nerve damage