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Despite the absence of a statistically significant doseresponse relationship observed in this analysis, clinical decision-making should consider that absorption efficiencyrather than absolute dosagemay be the limiting factor

Moreover, a US national study of 2,806 older women (50 years) found increased plasma concentration of methylmalonic acid the metabolic indicator of vitamin B 12 deficiency to be associated with increased risk of lumbar spine osteoporosis (115)

Lack of intrinsic factor

I go into this topic further in my Youtube video about B12: Common risk factors for low vitamin B12 levels in older adults include : Low levels of stomach acid

Because of their potential therapeutic effects, peptides have become a prominent focus in medical science and health care