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B12 injections are especially beneficial for patients experiencing fatigue, brain fog, or those with absorption issues from digestive conditions or dietary restrictions

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however, under certain conditions, such as environmental alterations, normally symbiotic organisms in the gastrointestinal tract have pathogenic potential, resulting in immune system activation and inflammatory disease [104,105]

The malabsorption of B12 can also occur in the small intestine after intrinsic factor has moved the B12 in there

Individuals who have had gastrointestinal surgery, such as weight loss surgery, may also have fewer cells through which to secrete stomach acid and intrinsic factor, inhibiting B12 absorption