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These medications reduce gastric acid production, which is necessary for releasing dietary vitamin B12 from food proteins and for maintaining the stability of the B12-intrinsic factor complex

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For example, production of the neurotransmitter, 5-HT/serotonin, was reportedly upregulated in the presence of spore-forming Clostridia species , while germ-free mice displayed lower 5-HT/serotonin levels in their colon and blood as well as reduced intestinal motility (Kashyap et al

Although meat and milk used to be a primary source of Vitamin B12, even livestock feed has to have B12 additives