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Absorption problems Even with adequate intake, absorption can be reduced by: Certain gastrointestinal conditions affecting the stomach or small intestine Some medications Age-related reduction in stomach acid (which can affect absorption) Autoimmune gastritis (often historically referred to as pernicious anaemia) This is a well-recognised cause of B12 deficiency and may require ongoing management

Roegner A, Giannitti F, Woods LW, Mete A, Puschner B (2013) Public health implications of lead poisoning in backyard chickens and cattle: four cases

However, its levels decline with age, sparking interest in spermidine supplementation as a means of supporting healthy ageing (Reference Madeo, Carmona-Gutierrez and Kepp18)

Although COX-2 appears as the key mediator in gastric wound healing, COX-1 becomes important when COX-2 is impaired (Schmassmann et al