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The vitamin B12 deficiency involved in pernicious anemia is not brought on by inadequate diet, but rather by a relatively rare condition that inhibits the absorption of vitamin B12 in the gut, per MedlinePlus Medical Encyclopedia

Sources Vitamin B12 - Consumer | National Institutes of Health VITAMIN B12: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews | WebMD Article Vitamin B12 Deficiency: Causes, Symptoms, and Treatment | WebMD Living longer isnt enough if you dont feel your best

For the next 80 days of skilled nursing care (days 21100), the beneficiary pays $209.50 per day in coinsurance

Drugs like phenytoin, metformin, and methotrexate can interfere with folate absorption or metabolism