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Jun 2005;24(2):121-4

Methylcobalamin : An active form that doesn't require conversion, though evidence for superiority over cyanocobalamin in UK clinical practice is limited

Sometimes our bodies need a bit more of this vitamin, especially if we don't get enough from our food

The cells in the stomach cannot produce enough intrinsic factor due to the inflammatory immune response

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Other factors associated with hyporesponsiveness include chronic occult blood loss, aluminum toxicity, cobalamin or folate deficiencies, testosterone deficiency, inadequate dialysis, hyperparathyroidism and superimposed primary bone marrow disease, and these should be addressed in patients whose anemia does not respond as expected to ESA therapy