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Low B12 levels can lead to megaloblastic anemia, a condition where red blood cells are abnormally large and unable to transport oxygen efficiently, causing symptoms like fatigue, weakness, and breathlessness

10.1016/j.jpba.2021.114040 14 FrudeE.McKayF

For this reason, this water sample should be collected from water that has sat in the pipes for at least six hours (called a first-draw" sample)

Many topical hair serums now combine both peptides for this reason

Intrinsic factor is only made in the stomach and after a gastrectomy there is little to no more of it or gastric acid, and the active mechanism in the body where B12 is absorbed is either less available or not available at all depending on if the surgery was a total or a part of a gastrectomy