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Fertility and Sterility, 82 (2), S228
The lack of vitamin B12 may result from any of the following conditions: Addisonian (pernicious) anemia this condition causes autoantibody formation against parietal cells, which results in a lack of IF essential for absorption of vitamin B12 from the intestine Malabsorption impaired absorption of vitamin B12 Gastrointestinal pathology, dysfunction, or surgery these include atrophic gastritis, celiac disease, small bowel bacterial overgrowth, pancreatic insufficiency, Helicobacter pylori infection, gastric carcinoma, and total or partial gastrectomy Diphyllobothrium latum and related species (the fish tapeworm) infestation these parasites compete with vitamin B12 for intestinal absorption

The 1858 C/T SNP of the PTPN22 gene is a risk factor for HT because it causes an arginine-tryptophan substitution at codon 620 (R620W), because decreased T cell signaling may results in poorer thymic elimination of autoreactive T cells, or an increased function of PTPN22 may lead to a decrease in regulatory T cells (Tregs) responsible for preventing autoimmunity