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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

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The metabolism of peptides and proteins usually starts from the action of endopeptidase and then undergoes multi-step enzymatic degradation to produce the final metabolite amino acids, which enter the amino acid pool in vivo (Vugmeyster et al., 2012)

National Academies Press (US).

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