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Malabsorption (insufficient absorption of vitamin B 12 in the intestine), insufficient production of intrinsic factor (a protein that is formed in the gastric mucosa and required to absorb vitamin B 12 ), Diseases in the end section of the ileum (part of the small intestine), e.g

The Quaker City had been part of the blockade at the mouth of Chesapeake Bay, between Cape Henry and Cape Charles, for 79 days

Curr Cardiol Rev

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Vitamin B12 is essential for the conversion of food into energy, helping to combat tiredness and improve overall vitality

Vitamin B12 supports a healthy metabolism by breaking down carbohydrates and converting fats and proteins into energy, according to Healthline