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Large randomized trials designed to detect rare adverse events are mostly absent in this area

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In contrast, there is some evidence of an enhancement of the maximum absorption via intrinsic factor, by up to a factor of 2, when the vitamin B12 is accompanied by food, but this is not consistently observed and probably only applies when the food quantity and vitamin B12 dose are sufficient to slow the passage of the vitamin B12 through the small intestine enough (about three hours or more) to allow each intrinsic factor receptor to absorb two molecules of vitamin B12 from the oral dose rather than one

Caregivers should also avoid self-diagnosing based on internet searches alone