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Age can also play a role, as stomach acid production often decreases in older individuals

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Chronic myeloid leukemia, polycythemia vera, and hypereosinophilic syndrome are the classic associations, and the mechanism is thought to be overproduction of haptocorrin or transcobalamin by the expanded cell population

No human safety data : The complete absence of human clinical trials means the safety profile, side effects, optimal dosing, and pharmacokinetics in humans are entirely unknown Animal-to-human translation is uncertain : Metabolic differences between mice and humans mean that the magnitude of effects (e.g., weight loss, grip strength improvement) may not translate

But some people, particularly those with absorption issues or those with a diet lacking in animal products, may need to find supplemental sources of vitamin B12