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Absorption problems Even with adequate intake, absorption can be reduced by: Certain gastrointestinal conditions affecting the stomach or small intestine Some medications Age-related reduction in stomach acid (which can affect absorption) Autoimmune gastritis (often historically referred to as pernicious anaemia) This is a well-recognised cause of B12 deficiency and may require ongoing management

BNF British National Formulary Chapter 9 Section 1.2 bnf.nice.org.uk/drug/hydrox

Athletes: High levels of physical activity can raise the bodys need for certain nutrients, such as vitamin B12

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Factorial Approach Researchers have attempted to determine B12 needs by measuring daily B12 body losses, also known as the factorial approach