Patients with gastrointestinal problems or those recovering from gastrointestinal surgeries are at a higher risk for Vitamin B12 deficiency symptoms . This can be expected since Vitamin B12 is absorbed in the intestines and requires a protein from the stomach to assist the digestive process.

How is Vitamin B12 Absorbed?

Vitamin B12 is one of the few nutrients that can begin absorption in the mouth. Unbound crystalline forms of B12 can be absorbed here, but most of the work begins in the stomach. Two things occur:

1. Acids in the stomach free the Vitamin B12 that was bound to a protein (from foods such as beef, poultry, shellfish, etc)
2. The stomach produces another protein called intrinsic factor that binds with the B12 and acts as a carrier for later absorption in the intestines. Without the intrinsic factor, Vitamin B12 can’t pass through the intestinal lining and be absorbed into the blood stream.

Failure with either of these processes result in a Vitamin B12 deficiency.

Gastric Bypass Surgery

Gastric bypass patients have a new smaller stomach and a portion of their small intestine is no longer used. As a result, they have two complications with the natural processing of B12. First, they don’t produce enough intrinsic factor in the stomach. Second, they have less small intestines to absorb the Vitamin B12. They end up with Vitamin B12 deficiency symptoms and must take supplements that are not swallowed such as an ear patch, injections or nasal spray.

Gastrointestinal Diseases

Patients suffering from Chron’s disease, ulcerative colitis, or celiac disease are also at risk. These diseases require extra care on the patients’ part to keep their digestive system working properly. A “flare up” can create significant complications for their entire body. When a flare up occurs, the intestines become inflamed and fail to absorb the proper nutrients. Because the stomach is still functioning properly to produce the intrinsic factor, Vitamin B12 supplements will suffice to ensure enough absorption when not in a flare up. If you have these conditions a nutritional supplement will help prevent a Vitamin B12 deficiency.