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post-gastric bypass surgery) Pregnancy Malabsorption diseases (Celiac Disease, Colitis, Crohns disease) Lack of or deficiency of stomach acid

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Nutrients like choline, methionine, inositol and vitamin B12 may contribute to key processes, such as methylation and one-carbon metabolism, that may influence how the body regulates metabolic activity, cellular energy production and fat transport

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Since there is not enough intrinsic factor for vitamin B12 to bind with and it cannot travel to the distal ileum to absorb into the blood, the body cannot absorb vitamin B12 properly