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The lack of vitamin B12 may result from any of the following conditions: Addisonian (pernicious) anemia this condition causes autoantibody formation against parietal cells, which results in a lack of IF essential for absorption of vitamin B12 from the intestine Malabsorption impaired absorption of vitamin B12 Gastrointestinal pathology, dysfunction, or surgery these include atrophic gastritis, celiac disease, small bowel bacterial overgrowth, pancreatic insufficiency, Helicobacter pylori infection, gastric carcinoma, and total or partial gastrectomy Diphyllobothrium latum and related species (the fish tapeworm) infestation these parasites compete with vitamin B12 for intestinal absorption

Weight often drifts back without supportive habits

Many protocols recommend washing with gentle cleanser and allowing complete drying before the microneedling session

doi: 10.1021/bi700425y

Vitamin B12 injections are commonly recommended for patients who have difficulty absorbing this essential vitamin through diet or oral supplements alone