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Vitamin B12 deficiency Many things can cause Vitamin B12 deficiency, but it is most commonly found in older adults who: Take certain medications, like antihistamines, antacids, or certain diabetes medications Have low levels of stomach acid due to medications or digestive problems Are heavy drinkers Have chronic stomach or small intestine issues like Crohn's disease Have had surgeries to remove some or all of the stomach or small intestine Have an autoimmune disease Follow a plant-based diet Despite the fact that Vitamin B12 deficiency is common in older adults, it often can go overlooked for years because it progresses very slowly, and the symptoms can be easily explained by aging or other common ailments