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When you swallow a B12 pill, several steps have to work for it to be absorbed: stomach acid and the enzyme pepsin must release B12 from food or the supplement, the stomach must secrete a protein called intrinsic factor that binds to B12, and the B12-intrinsic factor complex must reach the ileum (the end of the small intestine) where it is finally absorbed
Some patients notice improved energy or mental clarity within 2448 hours, whilst others experience no immediate change, particularly if deficiency is severe
These signs are often blamed on stress or age, but low B-12 can be part of the story
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