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They only detect what their internal reagents are formulated to react to

Conditions like pernicious anaemia (an autoimmune condition affecting a protein called intrinsic factor vital for B12 absorption), stomach issues (such as from reduced stomach acid or certain medications like proton pump inhibitors), intestinal disorders (like Crohns disease or coeliac disease), or even surgical removal of parts of the small intestine (e.g., gastric bypass surgery) can prevent proper absorption

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Kim YC, Won HK, Lee JW, Sohn KH, Kim MH, Kim TB, Chang YS, Lee BJ, Cho SH, Bachert C, Song WJ

Feng JJ, Maddirala NR, Saint Fleur A, Zhou F, Yu D, Wei F, et al

A pharmacokinetic study by Park et al