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Available options include: B12 Shots : Intramuscular injections (IM) are the most commonly used treatment because they bypass absorption barriers and deliver the vitamin directly into the bloodstream[21]

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The biggest influences to the above list include: Microbial balance (aka bacterial balance) Immuno-modulation Preventing pathogenic infiltration Supporting immune system due to good bacterias immune-modulating properties Production of metabolites: SCFA// short chain fatty acids (butyrate, propionate, acetate) BCAA// branched- chain amino acids (valine, isoleucine, leucine) Vitamin K Folate Riboflavin Niacin Pantothenic cid Biotin Vitamin B12 Vitamin B6 Leptin, ghrelin Gut lining integrity Deiodinase activity (T4 to T3 conversion) Nutrient absorption capacity Gut permeability affecting immune-modulation Digestive capacity HCL production Bile production and flow Motility & movement of matter through the GI tract