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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

and others show that the volatile oil of Artemisia argyi can significantly prolong the latency period of the hot plate reaction in mice, inhibit the number of writhing times in mice, improve the tail withdrawal pain threshold in rats, and counteract the uterine contraction in rats caused by diethylstilbestrol and oxytocin, thus exerting analgesic effects [51]

If neurological symptoms are present, seek same-day assessment, as urgent treatment may be needed to prevent irreversible damage

Raran-Kurussi, S

Science 367, eaau6977

Statistical analysis Data from clinical, cell culture, and mouse studies were analyzed using regression analyses and ANOVA with Sigma Stat software (SPSS, Chicago, IL)