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it can be taken as a pill or under the tongueis when there is a deficiency that can be caused by pernicious anemia, celiac or Crohns disease, or weight loss procedures such as gastric bypass surgery, which interferes with the bodys ability to extract vitamins from food

Pollard, B

However, certain periodontal pathogens, including Porphyromonas gingivalis , Klebsiella , Helicobacter pylori , Streptococcus , Veillonella , Parvimonas micra , and Fusobacterium nucleatum can endure harsh acidic environments and migrate to the intestine 24 , particularly in individuals with reduced gastric acid levels, such as those using proton pump inhibitors (PPIs) 25

Carr DB, Utzschneider KM, Hull RL, et al