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This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation

For people with absorption problems, such as pernicious anaemia, injections are medically necessary as oral supplements will not be absorbed effectively

[DOI] [PubMed] [Google Scholar] 212.Garg R, Gupta S, Maru GB

Thrombosis Prevention: Lets Drug the Microbiome