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Mechanisms involved are thought to include tracheal microaspiration of acid stimulating bronchospasm 30 and increased airway hyper-reactivity associated with acid reflux into the lower esophagus

Nonetheless, your body needs gastric acid to activate certain enzyme reactions to absorb vitamin B12

Given that B12 is a water-soluble vitamin, the majority of an injected dose is excreted through urine, leaving only a small fraction for absorption

The groups affected are elderly people and those following a strict vegetarian or vegan diet

To sum up, some patients report the worsening of symptoms within the first few days or weeks when they begin B12 shots

This leads to poor B12 absorption, even in those who consume sufficient dietary sources[11]