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1 Deficiency is often due to a lack of B12 foods in the diet, absorption issues, and/or genetic mutations that affect uptake

doi: 10.1530/EJE-07-0066 101 MassoudAFHindmarshPCBrookCG

This deficiency can stem from various causes, such as impaired gastric absorption due to factors like gastrectomy, bariatric surgery, and pernicious anemia (PA), impaired intestinal absorption from conditions like ileal resection and chronic pancreatitis, decreased intake, hemolysis, HIV, and drug-induced effects, such as from alcohol, proton pump inhibitors, and metformin

It was originally speculated that the peptide bound in these receptors and increased the rate of metabolism in fat cells, shifting them from a storage mode to a usage mode

If you have multiple vials, use the oldest ones first

If you buy three months of supply and your prescription changes or treatment pauses, those vials are still aging