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For patients with impaired liver function or genetic variants affecting B12 metabolism, methylcobalamin may be preferable

It can also reflect iron deficiency, blood sugar instability, hormone shifts, nervous system dysregulation, or chronic stress

But a huge number of meat eaters are also deficient and likely dont know it B12 is absorbed through the stomach, and our ability to assimilate it through the stomach wall decreases with age, as well as due to any stomach issues like IBS, Crohns, and Celiac Disease, and medications that impact the stomach like metformin, antacids, PPIs, and ibuprofen

methylcobalamin, the adenosyl ligand in vitamin B 12 is replaced by methyl