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Earlier shorter trials reported small statistically significant differences but the effect sizes were modest

Both of these problems mean that cobalamin deficiency is mainly caused by its insufficient intake (a common complication of a vegetarian or vegan diet) or intestinal absorption disorders of vitamin B12, which occur in the course of diseases of various origins (Table 1) [41]

Diagnosis typically involves blood tests including full blood count (showing macrocytosis), anti-intrinsic factor antibodies (which are specific for pernicious anaemia), and sometimes anti-parietal cell antibodies

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Finally, both cyano- and methyl-cobalamin supplementation to conventional C57BL/6J mice at 30 and 120 g/day similarly increased IL-12/23p40 levels in the colon

This is because issues with regular function of the gastrointestinal tract can prevent the proper release and absorption of the vitamin, which can cause a deficiency if not supplemented properly