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Common factors that can impair absorption include: Age-related decrease in stomach acid production Certain medications including proton pump inhibitors and metformin Gastrointestinal conditions like Crohn's disease or celiac disease Vegetarian or vegan diets (B12 is primarily found in animal products) Bariatric surgery or other digestive tract surgeries Pernicious anaemia (autoimmune condition affecting intrinsic factor) This is where vitamin B12 injections offer a significant advantagethey bypass the digestive system entirely, delivering this crucial nutrient directly to your bloodstream for immediate availability to your cells