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The paths through which oral and intestinal microbiota enter the CNS include translocation via the bloodstream and lymphatic system following increased intestinal permeability, direct neural pathways such as the vagus nerve, and disruption of the BBB through inflammatory mediators

Intrinsic factor is only made in the stomach and after a gastrectomy there is little to no more of it or gastric acid, and the active mechanism in the body where B12 is absorbed is either less available or not available at all depending on if the surgery was a total or a part of a gastrectomy

Senescent cells secrete pro-inflammatory factors

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If you want to understand the full mechanism, start with our All About Liposomes guide

This way, they can make sure patients get the best care possible