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A primary contributor is a poor diet, particularly one high in processed foods, sugar, and inflammatory fats, which can feed harmful gut bacteria and directly damage the gut lining

Alternatively, prolong the elution time by reducing the flow rate during elution

Lastly, age can reduce the amount of stomach acid, which is necessary for the release of B12 from food

Iddir M, Brito A, Dingeo G, Fernandez Del Campo SS, Samouda H, La Frano MR et al (2020) Strengthening the immune system and reducing inflammation and oxidative stress through diet and nutrition: considerations during the COVID-19 crisis

Historically, crops were grown using natural methods without pesticides, but yields were inadequate to support the rising population

While the exact mechanisms are not fully understood, it is believed that vitamin B12 deficiency may contribute to the accumulation of specific proteins in the brain, leading to the development and progression of Alzheimer's disease and dementia