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Malabsorption (insufficient absorption of vitamin B12 in the intestine) due to insufficient production of intrinsic factor (a protein produced in the lining of the stomach that is needed to absorb vitamin B12), disorders in the end section of the ileum (part of the small intestine), such as sprue, fish tapeworm infestation or blind loop syndrome (change in the course of the intestine after gastric surgery)
This difference should be factored into the decision-making process
Some patients may struggle to absorb enough B12 from diet or oral supplements, especially those with conditions like pernicious anemia, gastrointestinal disorders, or those who have undergone certain surgeries
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