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Medical Conditions, Surgeries, and Medications Lack of intrinsic factor (a protein made in the stomach thats needed for B12 absorption) - this condition is called pernicious anemia Thyroid disease HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) Autoimmune diseases like type 1 diabetes, where the immune system in the body attacks its own tissues Gastric bypass surgery (weight loss surgery) Chronic gastritis surgery Certain medications like heartburn drugs (proton pump inhibitors) which reduce stomach acid production Who Is At Risk of Vitamin B12 Deficiency

Would you say to someone who eats meat and can absorb B12 (which a PA patient cant do because they have no intrinsic factor): Oh you cant eat meat to get your B12 until Monday even though you are B12 deficient on Friday? This is unreasonable

One study found NNMT levels in visceral adipose tissue were 3.5 times higher in obese subjects compared to lean controls

As a critical molecule in cellular energy metabolism and DNA repair, insufficient NAD+ directly triggers a series of metabolic abnormalities, including impaired mitochondrial function, reduced energy metabolism efficiency, and weakened DNA repair capacity