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NICE says oral vitamin B12 replacement should be considered when diet is the suspected cause
This article reports what has been documented, not what should be done
In these cases, tiaminal B12 injection is a good way to get enough B12 without going through the digestive system
Individuals most likely to benefit include: Those with pernicious anemia People with gastrointestinal disorders (e.g., Crohns disease, celiac disease, chronic gastritis) Patients following bariatric (weight loss) surgery Older adults with absorption difficulties Strict vegetarians or vegans at risk for deficiency People taking medications that can decrease vitamin B12 levels Laboratory testing usually confirms B12 deficiency before starting injections
Vitamin B12 injections are medically necessary when a patient has severe deficiency, neurological symptoms requiring rapid correction, or a condition that prevents adequate oral absorption