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If the cells supply of glutathione is severely depleted and GSSG trafficking out of the cell exceeds the rate at which it can be reduced back to GSH, cellular defence against oxidative stress is impaired and the cell may experience critical membrane failure and even cell death as a result of lipid peroxidation due to lack of protective glutathione antioxidant action

Truhanov, and Liudmila G

Surgical procedures or conditions that affect the gut, such as gastric bypass surgery or celiac disease, can prevent intrinsic factors from binding to B12 and prevent the body from breaking it down before absorbing the vitamin