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Dietary insufficiency (low animal foods or no fortified foods/supplements) Medication effects (for example, long-term metformin or acid-reducing medications) Absorption conditions (such as pernicious anemia, certain GI conditions, or past stomach/intestinal surgery) Ask your clinician what they think the root cause isbecause take B12 is not the full plan if absorption is impaired

A key pathological mechanism implicated in SCI and DCM is neuroinflammation driven by prolonged activation of microglia and macrophages (M/M) in the central nervous system (Watanabe et al., 2015

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Annu Rev Cell Biol 6 : 433460