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Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (ingestion of corrosives, extensive neoplasia), and a number of conditions associated with a variable degree of gastric atrophy (such as multiple sclerosis, HIV infection, AIDS, certain endocrine disorders, iron deficiency, and subtotal gastrectomy)

While non-cancerous, his dermatologist said he is at a greater risk of melanoma

Most side effects fade as your body adjusts, and small changes handle the rest: Dry mouth: drink more water and chew sugar-free gum Trouble sleeping: take your dose early in the morning and limit caffeine after midday Faster heart rate: your provider checks your blood pressure and heart rate at follow-up visits

Oxentenko, MD Consultant, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota