Which factor is a principal cause of deficiency in Cobalamin (B12)?

Cobalamin (Vitamin B12) deficiency is primarily associated with inadequate absorption or intrinsic factor deficiency, often linked to various medical conditions. Chronic pancreatitis can lead to malabsorption of various nutrients due to impaired enzyme production and function. In the case of Cobalamin, the malabsorption can occur because pancreatic enzymes are necessary for the release of cobalamin from protein sources in the diet. If these enzymes are lacking, Cobalamin cannot be properly absorbed in the intestine, leading to deficiency.

Folate intake does not directly cause B12 deficiency; however, it can mask the symptoms of B12 deficiency. While chronic pancreatitis is a problem related to nutrient absorption, alcohol consumption primarily affects other aspects of nutrition and liver function rather than directly leading to Cobalamin deficiency through malabsorption. A high-protein diet usually does not contribute to B12 deficiency; instead, it is often associated with higher B12 intake from protein-rich foods like meat and dairy.

Thus, the association of chronic pancreatitis with malabsorption makes it a significant factor leading to Cobalamin deficiency due to impaired release and absorption mechanisms.