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The mechanism appears to be interference with erythropoiesis
In short, B12 keeps our brains sharp, energy levels up, and cells functioning correctly
B12 is necessary for the production of healthy red blood cells, which carry oxygen throughout the body
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Deficiency after gastric banding is therefore primarily related to: Reduced dietary intake and food tolerance , limiting consumption of B12-rich foods Use of acid-suppressing medicines (PPIs or H2RAs) , which can impair the release of B12 from food proteins and reduce absorption of food-bound B12 Crystalline B12 the form found in supplements and fortified foods does not require acid or pepsin for release
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