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In the case of pronounced absorption disorders, for example as a result of gastritis or after removal of the small intestine, in Crohn's disease, diverticulosis and the so-called blind-loop syndrome, there is a gradual decrease in the vitamin B12 store in the liver, which can turn into a manifest vitamin B12 deficiency

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Genuine choline deficiency contributes to hepatic fat accumulation which is exactly why choline is in the blend and why the fat-metabolism story sounds plausible

The dosing regimen varies depending on whether neurological symptoms are present: With neurological involvement: 1 mg intramuscularly on alternate days until no further improvement, then 1 mg every 2 months [3] [4] Without neurological involvement: 1 mg intramuscularly three times a week for 2 weeks, then 1 mg every 2-3 months for maintenance [3] [4] There is some evidence that high-dose oral B12 (1000-2000 micrograms daily) may be effective even in some malabsorption conditions, though UK practice still generally favours intramuscular treatment in these cases

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