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NICE Clinical Knowledge Summaries recommend B12 injections for: Pernicious anaemia an autoimmune condition affecting intrinsic factor production Malabsorption syndromes including coeliac disease and inflammatory bowel disease Post-surgical states particularly following gastrectomy or ileal resection Strict vegan diets when oral supplementation proves inadequate, though oral cyanocobalamin is usually sufficient for dietary deficiency Clinical trials demonstrate that B12 injections rapidly improve haematological parameters and neurological symptoms when deficiency is confirmed through blood tests

Oral B12 supplements have to pass through the gut, and absorption can be limited especially if you have digestive issues, take certain medications like metformin or antacids, or simply have low stomach acid

If prescribed, your program includes: A medical review by a licensed provider Ongoing provider support and follow-ups Text-based Health Coaching** Educational tools and resources A supportive community to help you stay on track Medication costs are separate from the monthly Shed membership

Antacid drugs that neutralize stomach acid, as well as acid-suppressing agents such as proton-pump inhibitors, can inhibit the absorption of vitamin B 12 by preventing its release from food in the stomach