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However, a diagnosis of folate deficiency should be considered in such patients when significant elevation in mean cell volume or hypersegmented polymorphonuclear leucocytes are found, especially in subjects with malnutrition, history of alcohol abuse, or in patients hyporesponsive to rHuEPO

Enzymatic degradation in the digestive tract substantially reduces bioavailability, often to the point where clinical benefits become questionable

And if the PA is so far advanced that there is no intrinsic factor left, the antibodies can disappear

Which means that vegan and vegetarian diets must be diligent in finding sources or supplements of B12 (due to their animal origins)

PubMed: 10906314 GH Receptor-Independent Lipolytic Activity of AOD 9604 in Growth Hormone Receptor-Deficient Mice animal Hefti FF, Frazier-Higgins D, Duong TT, et al