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The volume of BAC water used determines the final concentration of the solution

Common reasons include: Pernicious anemia , an autoimmune condition affecting intrinsic factor production Gastrointestinal disorders, such as Crohns disease or celiac disease Prolonged use of certain medications, like proton pump inhibitors Knowing these causes helps spot at-risk people

and is useful in some cases of allergies by virtue of its ability to reduce histamine release

Physical examination may reveal pallor, glossitis, neurological signs such as reduced vibration sense or proprioception, and in advanced cases, ataxia or cognitive impairment

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Renal effects, including acute kidney injury, have been reported rarely in post-marketing surveillance, typically in the context of severe gastrointestinal adverse effects leading to dehydration