Vegetarians and vegans lack dietary B12 sources unless they consume fortified foods
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Evidence ranges from early laboratory work to clinical trials depending on the use the sections below cover the actual data and sources
[91] Since only bacteria and some archea possess the genes and enzymes necessary to synthesize vitamin B 12 , plant and algae sources all obtain the vitamin secondarily from symbiosis with various species of bacteria, [5] or in the case of fermented plant foods, from bacterial fermentation
Symptomatic vitamin deficiency is more likely if the person is rendered achlorhydric (a complete absence of gastric acid secretion), which occurs more frequently with proton pump inhibitors than H 2 blockers