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This is why, at the beginning of the 20th century, when it was discovered that eating liver improved patients with pernicious anemia, they had to eat huge amounts to achieve a pharmacological effect. In these cases, we find an approximate absorption of, with luck, between 1-2% of the dose administered, but it is not uncommon for it to be even lower (0.5%) depending on the size of the dose, previous reserves, and other factors and individual conditions of each subject

Even meat-eaters can be deficient

Studies have found that women taking birth control that contains estrogen tend to have higher vitamin D levels than those who dont, and the effect of vitamin D supplements is improved for those on birth control [31]

The mechanism of gastric bypass surgery is to cause restriction by creating a smaller stomach pouch and then causing nutrient malabsorption by bypassing a portion of the stomach and small intestine