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Surgical procedures or conditions that affect the gut, such as gastric bypass surgery or celiac disease, can prevent intrinsic factors from binding to B12 and prevent the body from breaking it down before absorbing the vitamin

Then, they get weekly shots

Vacuolar assimilation of the majority of solutes is stimulated by two vacuolar proton pumps: a vacuolar proton-ATPase (V-ATPase) and a vacuolar proton pyrophosphatase (V-Ppase) (Hossain et al., 2012)

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Crystal structure of SARS-CoV-2 Orf9b in complex with human TOM70 suggests unusual virus-host interactions