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Research Limitations Current evidence has limitations

Il conviendra de surveiller l'efficacit du traitement en mesurant l'acide mthylmalonique dans les urines ou la transcobalamine sanguine en particulier en cas d'insuffisance urinaire

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Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (which can be caused by ingestion of corrosives, extensive tumors, and conditions associated with gastric atrophy, such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy) Structural lesions leading to vitamin B 12 deficiency, including regional ileitis, ileal reactions, and malignancies Competition for vitamin B 12 by intestinal parasites or bacteria