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Since your body does not make it, you have to get B12 from food or supplements

While the condition is the major cause of poor vitamin B 12 status in the elderly population, it is usually associated with atrophic gastritis, a chronic inflammation of the lining of the stomach that ultimately results in the loss of glands in the stomach (atrophy) and decreased stomach acid production (see Atrophic gastritis)

Co-enzyme B12 also interacts with the enzyme methionine synthase (5-methyltetrahydrofolate-homocysteine methyltransferase), required for the conversion of homocysteine to methionine, which is essential for folic acid metabolism and the formation of thymine, which is a component of DNA

Methylcobalamin, while slightly less stable, remains safe and effective when handled properly in a clinical setting