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Several factors can impair B12 absorption: Reduced stomach acid production (achlorhydria or hypochlorhydria), common in older adults and those taking proton pump inhibitors or H2-receptor antagonists long-term, impairs the release of B12 from food proteins Pernicious anaemia , an autoimmune condition destroying parietal cells and reducing intrinsic factor production, completely blocks the primary absorption pathway Gastrointestinal disorders including Crohn's disease, coeliac disease, or surgical removal of stomach or ileum sections directly damage absorption sites Metformin , commonly prescribed for type 2 diabetes, may reduce B12 absorption through unclear mechanisms

Cambridge University Press (CUP)

Structural aspects of the allosteric inhibition of fructose-1,6-bisphosphatase by AMP: the binding of both the substrate analogue 2,5-anhydro-D-glucitol 1,6-bisphosphate and catalytic metal ions monitored by X-ray crystallography

Although the studies performed with humans can be expanded to include a much larger cohort of patients, the clinical benefit observed with smaller cohort of patients treated with NAC in this study indicated safety, feasibility and efficacy of NAC in bleaching, and provided the basis for its potential inclusion in the bleaching protocol for the health and comfort of dental patients in aesthetic dentistry

But hydration is just the beginning