The 2 main reasons a woman has b-12 deficiency are lack of intake and lack
of absorption. The lack of absorption can occur due to pernicious anemia or
to malabsorption of vitamins due to other reasons such as surgical removal
of part of the small intestine. The issue with older women is that
pernicious anemia occurs in people as they get older. Pernicious anemia is
a condition where the stomach does not make enough intrinsic factor, and
this factor normally attaches to vit b-12 to allow its absorption through
the gut wall. The diagnosis is made by doing a shillings test, which I
won't get into here. The treatment of pernicious anemia is parenteral
administration of b-12 , ie shots. Hope this helps-Anne Eglash MD