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[DOI] [PubMed] [Google Scholar] De Mora S, Sheikholeslami MR, Wyse E, Azemard S, Cassi R

B12 injections are clinically indicated for patients with confirmed deficiency or malabsorption conditions, including those with pernicious anaemia, gastrectomy, ileal resection, Crohn's disease, or neurological symptoms related to B12 deficiency

Whether this is optimal or simply reflects empirical practice isnt established

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As we age, our stomachs produce less acid, making it harder to absorb B12 from foodeven if we're eating all the right things