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DOI: 10.1089/105072504323031013 26

analyzed the data and assisted in manuscript preparation

The lack of vitamin B12 may result from any of the following conditions: Addisonian (pernicious) anemia this condition causes autoantibody formation against parietal cells, which results in a lack of IF essential for absorption of vitamin B12 from the intestine Malabsorption impaired absorption of vitamin B12 Gastrointestinal pathology, dysfunction, or surgery these include atrophic gastritis, celiac disease, small bowel bacterial overgrowth, pancreatic insufficiency, Helicobacter pylori infection, gastric carcinoma, and total or partial gastrectomy Diphyllobothrium latum and related species (the fish tapeworm) infestation these parasites compete with vitamin B12 for intestinal absorption

Instead, the change tends to feel like the heavy, dragging feeling slowly lifting

This translates to more sustained energy, better metabolic flexibility and easier maintenance of lean body composition over time

There are a variety of issues that may increase the risk or trigger your symptoms