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In our review, some ( Patients with vitamin B12 deficiency who are symptomatic have severe neurological deficits or have critically low blood levels of vitamin B12 should be treated with IM administration

Intrinsic factor is a glycoprotein produced in the stomach

Proton pump inhibitors (acid blockers) and over-the-counter non-steroidal anti-inflammatory agents can change the environment of the GI tract predisposing to nutrient deficiencies Unfortunately, that isnt an exhaustive list, but it does give you a pretty good idea of why you should be concerned about your vitamin B12 levels

Expect a supervised process: a consultation and baseline labs first, then learning the routine and starting conservatively, followed by check-ins as your provider fine-tunes the plan