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Other causes are conditions affecting the stomach or small intestine, such as Crohns disease, operations such as gastrectomies (which involve removal of part of the stomach), and certain medications

Your body might not be absorbing the vitamin at a steady rate when you are taking supplements, and thats where a Vitamin B12 shot can help accelerate the process

It is therefore entirely plausible that chronic saturation of this receptor complex by UMFA could interfere with the reuptake and retention of their respective ligands, including holoTC and vitamin B-12, and this effect could be accentuated in individuals with renal insufficiency