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Investigators have assessed multiple administration routes, including subcutaneous, intramuscular, intravenous, oral, and topical delivery in experimental models
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Common reasons include: Pernicious anemia , an autoimmune condition affecting intrinsic factor production Gastrointestinal disorders, such as Crohns disease or celiac disease Prolonged use of certain medications, like proton pump inhibitors Knowing these causes helps spot at-risk people
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However, the Academy of Nutrition and Dietetics considers plant and algae sources "unreliable", stating that vegans should turn to fortified foods and supplements instead
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