5 Reasons Why B12 is NOT Being Absorbed

author avatar Dr. Eric Berg 02/27/2024

Imagine feeling constantly tired, no matter how much you sleep or what you eat. Vitamin B12 scarcity, an elusive ailment that often flies under the radar, might be the culprit behind your perpetual fatigue.

In this deep dive, we'll explore why some folks struggle to get enough B12 from their diet alone. We're covering everything from the crucial role of stomach acid in absorption to how certain health conditions can throw a wrench in the works.

You'll walk away knowing more about how your body handles this vital nutrient and what steps you can take if you suspect your levels are low. Let's crack the code on B12 absorption together.

Understanding B12 and Its Importance

Vitamin B12, a nutrient as stealthy as it is essential, hides in your body attached to a mineral buddy called cobalt. This pairing makes B12 uniquely protein-bound, allowing it to stick around for several years without saying goodbye.

Think of it like the one guest at your party who's always there until the very end - that's how committed B12 is to your well-being. Vitamin B12, in its steadfast dedication, acts as a crucial cog in the machinery of our bodily functions.

This vitamin is quite the multitasker, from aiding in the production of DNA and red blood cells to supporting nerve function and energy levels.

However, despite its crucial roles and impressive storage capabilities within our bodies, its absorption can sometimes hit roadblocks due to various factors, such as certain medications or health conditions.

The Role of Stomach Acid in B12 Absorption

Imagine your stomach without enough acid. It's like trying to cook pasta in cold water; it just doesn't work. That's how crucial stomach acid is for vitamin B12 absorption.

Stomach acid flips the switch on pepsin, a mighty enzyme, ensuring it chops up B12 for your body's use, much like how you need hot water to cook pasta properly.

Without sufficient stomach acid, pepsin remains inactive, leaving B12 stuck and unable to be adequately absorbed.

The Impact of Antacids

Antacids might seem like lifesavers when battling heartburn, but think twice before making them your go-to remedy. These over-the-counter helpers reduce the production of stomach acid, which is vital for extracting vitamin B12 from food.

This reduction hampers digestion and significantly interferes with the natural process required for effective B12 absorption. In other words, popping antacids too frequently could lead you to nutritional deficiencies without realizing it.

Health Conditions Affecting B12 Absorption

Health conditions such as pernicious anemia, atrophic gastritis, and gastrointestinal surgery can affect the absorption of vitamin B12. Pernicious anemia is an autoimmune condition where the body attacks cells in the stomach, leading to impaired B12 absorption.

Atrophic gastritis involves inflammation and thinning of the stomach lining, reducing the production of intrinsic factors needed for B12 absorption.

Gastrointestinal surgeries, particularly those involving removing parts of the stomach or small intestine, can also interfere with B12 absorption.

Gastric Issues and Their Effects

Your stomach is like a VIP lounge for Vitamin B12 absorption, but specific health issues can act as bouncers, keeping B12 out. For instance, atrophic gastritis reduces your stomach's ability to produce the acid necessary for breaking down food and releasing B12.

Similarly, surgeries such as gastric bypass dramatically alter the digestive system’s structure, directly impacting how nutrients are absorbed.

Conditions like celiac disease, Crohn's disease, or irritable bowel syndrome (IBS) also mess with your gut's inner workings. They cause inflammation or damage to parts of the GI tract where critical digestion and nutrient absorption occur.

The Role of Intrinsic Factor

Intrinsic factor is essentially the golden ticket that lets Vitamin B12 into your body’s bloodstream from the gut.

However, when conditions like atrophic gastritis attack the stomach lining where intrinsic factor is produced, it becomes challenging for your body to absorb this crucial nutrient effectively.

When not tackled aptly, this predicament may precipitate grave health complications. This production can plummet, leading to poor B12 uptake no matter how much you get through diet or supplements.

Three different faces of a woman

Symptoms of B12 Deficiency

Are you feeling more like a zombie than your usual perky self? It might not just be the lack of coffee. A sneaky culprit behind fatigue, memory fog, and mood swings could be a Vitamin B12 deficiency.

Essential for maintaining nerve function, crafting red blood cells, and constructing our genetic blueprint, this nutrient plays a pivotal role.

If you've ever experienced that weird sensation of pins and needles in your hands or feet without apparent reason, it's time to pay attention. That’s one sign your body might be running low on B12.

But it doesn’t stop there; depression, paranoia, delusion - sounds like the lineup for a horror movie cast but are symptoms associated with severe cases of B12 deficiency.

Anemia often joins this unwelcome party due to insufficient red blood cells. And let's not forget about physical signs – imagine looking at your tongue in the mirror only to find it swollen or redder than usual.

These are all alarm bells worth listening to if you're concerned about your Vitamin B12 levels.

Solutions for Enhancing B12 Absorption

To enhance B12 absorption, individuals can opt for fortified foods such as fortified cereals, plant-based milk, or nutritional yeast. Additionally, consuming B12 supplements or getting B12 injections may be necessary for those with absorption issues.

Including folate-rich foods, such as leafy greens and legumes, can also support B12 absorption and overall health.

Dietary Adjustments

Boosting your Vitamin B12 absorption starts with what you put on your plate. Think of your gut as a garden; it needs the proper nutrients and care to flourish.

Incorporating animal products like beef, chicken, fish, and dairy is critical because they're packed with B12 bound to protein—a form our bodies can easily use.

But it's not just about what you eat—it's also how you prepare for digestion. Adding an acidic touch to meals through lemon juice or apple cider vinegar can prime your stomach for better nutrient absorption.

Supplemental Support

Supplements might be the next step if dietary changes aren't cutting it. Methylcobalamin stands out as a superstar form of Vitamin B12 because its high doses are especially effective at preventing deficiency symptoms.

To get technical without getting lost in jargon—think of methylcobalamin as a VIP pass that lets Vitamin B12 bypass usual entry barriers into your system.

Items such as Zypan, by melding intrinsic factors with betaine hydrochloride, morph into formidable partners that boost absorption by maintaining prime acidity conditions within the stomach.

Woman with stomach pain

Addressing Poor B12 Absorption: Its Common Causes and Remedial Strategies

When addressing poor B12 absorption, understanding common causes is crucial. Gastrointestinal issues, certain medications, and dietary restrictions can hinder B12 absorption.

Remedial strategies vary, but one important consideration is choosing between methylcobalamin and cyanocobalamin forms of B12 supplements.

While cyanocobalamin is more commonly used and stable, methylcobalamin is believed to be more bioavailable and better suited for those with absorption issues.

Consulting with a healthcare professional can help determine the most effective approach, including the choice between Methylcobalamin and Cyanocobalamin.


Unlocking the mystery behind the causes of poor B12 absorption is just the start.

You've learned how vital B12 is for your health and that stomach acid isn't always the bad guy we think it is.

Many factors are at play, from antacids throwing off your balance to various health conditions putting up roadblocks. Yet, bearing in mind, this wisdom empowers you to take control.

To tackle this issue head-on, adjusting your diet and considering supplements can be game changers.

Think methylcobalamin or a dash of apple cider vinegar; small changes might lead to significant improvements.

So, if you're feeling off-track with fatigue or memory fuzziness, consider looking into your B12 levels because understanding these causes offers insight and actionable steps toward better health.

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