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Pernicious anemia is specifically associated with a deficiency of vitamin B12. This condition occurs due to the body's inability to properly absorb vitamin B12 from the gastrointestinal tract, typically because of a deficiency in intrinsic factor, a protein produced in the stomach that is essential for the absorption of this vitamin. Without sufficient vitamin B12, the production of healthy red blood cells is impaired, leading to various symptoms associated with anemia, such as fatigue and weakness.

Vitamin B12 is crucial for the formation of red blood cells and the maintenance of the nervous system. As a result, a deficiency can lead to not only anemia but also neurological problems. This underscores the importance of vitamin B12 in overall health, particularly in forming DNA and in the metabolism of every cell in the body.

Other options, such as vitamin B6, iron, and folate, are related to other types of anemia or health conditions but are not directly responsible for pernicious anemia. Understanding the specific role of vitamin B12 in pernicious anemia can help in recognizing the symptoms and the importance of dietary sources or supplementation of this vital nutrient in prevention and treatment.