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Gastrointestinal malabsorption: Patients with Crohns disease, celiac disease, gastric bypass or intestinal surgery often cant absorb B12 properly

According to USDA Agricultural Research Service data based on NHANES, approximately 6% of adults aged 60 and older in the United States are vitamin B12 deficient, defined as plasma B12 below 148 pmol/L (2009)

Interestingly, greater benefits were seen in those with high compared to low homocysteine concentrations at baseline, suggesting the importance of lowering homocysteine levels in prevention of brain atrophy and cognitive decline (91-93)

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Studies show promising results for osteoarthritis when combined with hyaluronic acid, though more research is needed

However, its common for blood tests to reveal inaccurate information regarding B12 levels since a high percentage is stored in the liver and not always revealed through testing