Groups at higher risk of deficiency include older adults (due to reduced stomach acid production), people following vegan or strict vegetarian diets (as B12 is naturally found almost exclusively in animal products), individuals with pernicious anaemia or other malabsorption conditions, those taking certain medications such as metformin or proton pump inhibitors long-term, and people with significant nitrous oxide exposure (including recreational use), which can inactivate B12 in the body
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One 10 mg vial provides roughly 1620 days of material at the 600 mcg/day target, and longer during the ramp weeks
Leucovorin is very similar to folic acid, says Dr David Mandell, professor of psychiatry at the University of Pennsylvania Perelman School of Medicine
If you take B12 supplements, multivitamins, or receive B12 injections, the high result is almost always a reflection of your intake and is clinically insignificant
Some people may have poor B12 absorption due to genetics and therefore need an individual B12 intake plan to maintain healthy levels (Temova Rakua et al., 2022)
