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People with Absorption Issues Several conditions can impair B12 absorption: Pernicious anaemia An autoimmune condition thats the most common cause of severe B12 deficiency in the UK Crohns disease or coeliac disease Previous gastric surgery Including gastric bypass Chronic use of certain medications Including proton pump inhibitors (PPIs), metformin, and some anti-seizure medications Others at Risk Pregnant and breastfeeding women (who have increased B12 requirements) Heavy alcohol consumers Those with chronic inflammation affecting gut health People taking certain oral contraceptives B12 Deficiency in the UK: How Common Is It

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One reason is being low in a type of compound produced within the stomach called intrinsic factor (a type of glycoprotein), which combines with vitamin B12 once consumed in order to allow it to be absorbed

Regulatory standards for supplement manufacturing are less stringent than those for pharmaceuticals, which contributes to contamination and mislabeling