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Deficiency after gastric banding is therefore primarily related to: Reduced dietary intake and food tolerance , limiting consumption of B12-rich foods Use of acid-suppressing medicines (PPIs or H2RAs) , which can impair the release of B12 from food proteins and reduce absorption of food-bound B12 Crystalline B12 the form found in supplements and fortified foods does not require acid or pepsin for release

Elimination occurs primarily through renal clearance, with a plasma half-life of approximately 2-4 hours in rodent models

Leukocytospermia is associated with increased reactive oxygen species production by human spermatozoa