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Conditions like pernicious anaemia (an autoimmune disorder where your body cant absorb B12 from food), certain stomach conditions, medications that reduce stomach acid, or even gastrointestinal surgeries (like weight loss surgery) can prevent your body from properly taking in B12, even if youre getting enough in your diet

However, individual tolerance varies, and some patients find spicy foods exacerbate gastrointestinal side effects such as nausea or heartburn due to delayed gastric emptying