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Your Overall Health Underlying health conditions, such as gastrointestinal disorders (like Crohns disease, celiac disease, or atrophic gastritis) that impair nutrient absorption, or certain medications you may be taking, can influence how your body absorbs and utilizes B12

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Nebert DW, Dalton TP

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This pathway is considered the most genotoxic as the 4-OH estrogen metabolites can become reactive quinones that have the potential to bind to DNA and form damaging (unstable) depurating adducts, that may increase risk for cancer, such as breast and prostate cancer