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To absorb B12 from food or from a pill, your body needs three things working together: Stomach acid , which releases B12 from the protein it is bound to Intrinsic factor , a protein your stomach lining makes that escorts B12 through your gut A healthy small intestine , specifically the last section, where B12 is finally taken in Should even one of these three steps break down, absorbing B12 from a tablet becomes difficult

That idea is an extrapolation from rat data