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Anushiravani A, Haddadi N, Pourfarmanbar M, Mohammadkarimi V

While the connection exists, doctors usually investigate more common causes first, including poor nutrition, medication use, pernicious anemia, or digestive disorders like Crohns disease

McAdams C, Leonard BE (1993)

57 however, these mechanisms remain unelucidated

If the patient is suspected to be sensitive to cobalt or other components of cobalamin, an intradermal test dose is recommended (10, 13)

Since those who train are typically much leaner than the average Joe, this should concern you (I'm assuming most anyone reading this trains regularly), especially when you're in a "get-lean" phase