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पाचन संबंधी समस्याएं (Malabsorption Issues) कभी-कभी खाना तो सही खा रहे हैं, लेकिन शरीर B12 को अवशोषित (absorb) नहीं कर पाता। इसके कारण हो सकते हैं: घातक एनीमिया (Pernicious Anemia) – शरीर के अपने antibodies B12 को नुकसान पहुंचाते हैं Celiac या Crohn's रोग – पाचन तंत्र को नुकसान पिछली सर्जरी – पेट या आंत की सर्जरी से absorption क्षमता घट जाती है 3