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References Chen Z, Xu L, Shi W, Zeng F, Zhuo R, Hao X, et al

Oral B12 absorption depends on stomach acid levels and the presence of intrinsic factor, both of which can be unreliable

Passive diffusion accounts for 1.2% of overall absorption, with little effect on bioavailability in patients with pernicious anemia or gastro-duodenal resection [49, 50]

Cautious use of parenteral cyanocobalamin is also recommended in patients with renal impairment, including premature neonates, because of the possibility of greater aluminum accumulation, which may cause central nervous system and bone toxicity

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Vitamin B-9 (folic acid) Vitamin B-9 (folate or folic acid) helps your body metabolize amino acids