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Other malabsorption causes include: Atrophic gastritis and reduced gastric acid production (common in older adults) Gastrointestinal surgery, particularly gastrectomy, ileal resection, or bariatric surgery (especially gastric bypass) Inflammatory bowel disease affecting the terminal ileum (Crohn's disease) Coeliac disease and other small bowel disorders Chronic pancreatitis affecting enzyme secretion Helicobacter pylori infection (may contribute to reduced absorption) Medication-related deficiency is increasingly recognised

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So, for example, if people lose an average of one microgram of B12 a day, and the bioavailability of tiny amounts of B12 from food is assumed to be about 50%, if you got two micrograms a day, youd absorb one microgram50%and that would replace the one microgram you lose every day

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