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Conversely, pregnancy, oral contraceptive use, and paraproteinaemia may cause assay interference leading to spurious high or low readings

Some products use higher B12 concentrations to account for differences in how the body processes this form. In addition, evidence published in Cureus suggests that methylcobalamin may be retained more efficiently in the body than cyanocobalamin, making it a relevant consideration for those with impaired conversion due to genetic MTHFR variations

pylori infection chronic excess alcohol use pancreatic insufficiency intestinal bacterial overgrowth Gastrectomy/ bariatric surgery and gastritis Causes of food cobalamin malabsorption can be directly related with the stomach: Bariatric surgery it can depend on the type of procedure and what area of the stomach or intestines are removed Gastrectomy removal of part or all of the stomach Gastritis inflammation of the stomach lining Gastrectomy, bariatric surgery, and gastritis cause vitamin B12 deficiency due to an absence of stomach acids that help to remove vitamin B12 from food proteins, for example red meat

It is not approved as a drug for any condition by the FDA, EMA, or other major regulators