B12 from food and supplements has to pass through a fairly involved process in the stomach and gut before your body can use it, and that process becomes less efficient with age, with certain medications, and with diets that include little or no animal protein
Importantly, a mutation in PNPLA3 (rs738409), I148M, is the single greatest genetic risk factor for the development of FLD (64-67), however its precise function in neutral lipid metabolism is controversial (68, 69)
Your healthcare provider will recommend a schedule based on your individual needs and weight-loss goals
Other malabsorption causes include: Atrophic gastritis and reduced gastric acid production (common in older adults) Gastrointestinal surgery, particularly gastrectomy, ileal resection, or bariatric surgery (especially gastric bypass) Inflammatory bowel disease affecting the terminal ileum (Crohn's disease) Coeliac disease and other small bowel disorders Chronic pancreatitis affecting enzyme secretion Helicobacter pylori infection (may contribute to reduced absorption) Medication-related deficiency is increasingly recognised
Treatment decisions are made by a licensed provider after reviewing each patients medical history
