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Unlike most vitamins, B12 has a uniquely complex absorption pathway: Stomach acid and pepsin release B12 from food proteins B12 binds to R-proteins (haptocorrins) in saliva and stomach Pancreatic enzymes release B12 from R-proteins in the small intestine B12 binds to intrinsic factor (produced by gastric parietal cells) The B12-intrinsic factor complex is absorbed in the terminal ileum A breakdown at any of these five steps causes deficiency which is why B12 deficiency is far more common than dietary intake alone would predict

This distinction affects how the compound is absorbed, metabolized, and utilized in the body

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