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Pernicious anemia occurs more commonly in people who already have diseases that are linked to immune-system abnormalities, such as Graves disease, hypothyroidism (under-functioning thyroid gland), thyroiditis (inflammation of the thyroid), vitiligo, and Addison's disease (adrenocortical insufficiency)

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Vitamin B 12 is also available in the form of pills that dissolve under the tongue, and as a nasal spray and nasal gel