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These include: Pernicious anaemia : An autoimmune condition where the body cannot produce intrinsic factor, preventing B12 absorption Crohn's disease or coeliac disease : Conditions affecting the ileum, where B12 is absorbed Previous gastric surgery : Including gastric bypass or removal of parts of the stomach or small intestine Atrophic gastritis : Chronic inflammation of the stomach lining Medication users may experience reduced B12 absorption

This is one of the main reasons it is discussed as an alternative or adjunct to more familiar options such as NSAIDs

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USA 112 , 39613966 (2015)