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The phenotypic outcome is a shift toward higher energy expenditure and improved adipose/lipid profiles without the catabolic loss of lean tissue commonly seen with severe caloric restriction

The NIH reports that only about 10 micrograms of a 500-microgram oral supplement are actually absorbed in healthy people due to limitations of stomach acid and intrinsic factor

The elderly (reduced absorption) Pernicious anemia Vegetarians / Vegans (low dietary B12) People taking metformin or acid reflux medications (PPIs) Post-bariatric or gastric-bypass patients Genetic variants in MTRR , MTR , or TCN2 What Has B12 Been Studied For

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Groups switched from WD to LD had a greater average relative abundance of Verrucomicrobia (represented solely by the genus Akkermansia )