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medicines.org.uk/emc Jastreboff AM, et al

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If you have diabetes, a thyroid disorder, take antacids, or smoke or drink too much, you may also be at risk of a B12 deficiency

And while it can be possible to delay or drop Medicare Part B coverage after enrolling, there generally isn't any way to 'turn off' Part A once it's started (other than withdrawing one's application for Social Security benefits entirely, about which more is discussed later on)

Causes of the condition are not fully defined, but at least part of the problem can be contributed to an infection in honey bee guts by the fungus Nosema ceranae