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doi: 10.1093/JMCB/MJZ026 38 Freed-PastorWAPrivesC

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So people at greatest risk for deficiency include those with low stomach acid (e.g., older adults and people on proton pump inhibitors or antacids) or low IF production (known as pernicious anemia), people on medications that interfere with B12 absorption (such as metformin), people who have had gastric surgery, those with GI conditions that impair nutrient absorption (like celiac or Crohn's disease), and people on vegan and vegetarian diets

On the other hand, excessive RS production can also lead to disorders, most commonly prolonged inflammation and related tissue injury (Mittal et al., 2014)