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A normal vitamin B12 level is between 160 and 950 picograms per milliliter (pg/mL), but this can vary slightly between laboratories. A level below 200 pg/mL is considered low, and levels between 200 and 300 pg/mL are considered borderline. Vitamin B12 deficiency can be caused by: Diet Vegans and vegetarians are at higher risk because vitamin B12 is mainly found in animal products. Medications Some medications, such as metformin, proton pump inhibitors, histamine H2 blockers, and oral birth control pills, can cause low vitamin B12 levels. Digestive disorders Celiac disease, Crohn's disease, and atrophic gastritis can make it difficult for the body to absorb vitamin B12. Age People over 75 are more likely to be deficient because their bodies may not absorb vitamin B12 as well. Alcoholism Chronic alcoholism can damage the digestive system and lead to vitamin B12 deficiency. A doctor can prescribe a vitamin B12 test, or you can buy a test kit at a walk-in lab or online. It's important to discuss the results with a doctor