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Alici, E

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not present in plants Daily requirement: ~ 23 g/day Body stores: 25 mg , mostly in the liver (sufficient for 25 years) Absorption Pathway : In the mouth/stomach: B12 is protein-bound in food Stomach acid and pepsin release B12 from food proteins B12 binds to haptocorrin (also called R-binder or transcobalamin I) secreted by salivary glands and gastric mucosa In the small intestine : In the duodenum , pancreatic proteases degrade haptocorrin Free B12 then binds to intrinsic factor (IF) , a glycoprotein secreted by gastric parietal cells The B12IF complex travels to the terminal ileum , where it binds to cubilin receptors and is absorbed via receptor-mediated endocytosis 1 In the enterocyte and bloodstream: Inside enterocytes, B12 dissociates from IF It binds to transcobalamin II (TCII) for systemic transport Only B12TCII complex (called holotranscobalamin ) is biologically active and taken up by tissues Storage and transport: B12 is stored in the liver (main site), but also in muscle Transcobalamin II transports active B12 to tissues

They should be started at the lowest dose because they can have GI side effects like nausea, vomiting, diarrhea, and constipation

Its often needed for those with gallstones or cholecystitis