Malabsorption from coeliac disease, Crohns, gastric surgery or long-term metformin and proton-pump inhibitors accounts for much of the rest
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More specifically, it causes the active forms to convert to cyanocobalamin, causing a functional deficiency
However, as is the case with any supplement or injection, the results are going to vary for each person
By combining these agents in a single injection, the formulation may improve patient adherence to treatment protocols while potentially reducing the burden side effects or and multiple injections or medications, as determined by necessary by the prescribing physician
Bad kidney function can cause too much B12 to build up, leading to problems