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Two reasons for this could be following a vegan or vegetarian diet or having a certain medical condition like pernicious anaemia

Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step

[1] [2] Other uses include treatment for cyanide poisoning, Leber's optic atrophy, and toxic amblyopia

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Its transformed into previtamin D3 and then undergoes conversion in the liver and kidneys until it reaches the active form, 1, 25-dihydroxyvitamin D3, otherwise known as calcitriol or vitamin D3 for short