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PMID 41966639

One cause of B12 deficiency includes pernicious anemia, a condition that results in a reduction of red blood cells when the intestines cannot absorb enough vitamin B12

In 2019, an internal medicine specialist could not find an objective cause for his B12 deficiency, and supplementation was stopped

While they recommend considering an anti-intrinsic factor autoantibody test if AIG is suspected, the guidelines do not adequately explain why general practitioners should suspect an autoimmune basis beyond typical gastrointestinal symptoms

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Moreover, the complex mixture of intracellular ligands (free amino acids, other small molecules, adventitious binding sites on the surface of macromolecules), that can be assembled into a diversity of coordination sites with limited geometric constraint, provides an ideal mixture which will inevitably buffer according to the Irving-Williams series [201]