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B-12 injections are usually administered into an area of muscle, sites include the upper arm, buttocks and abdomen

Taking high-dose oral B12 supplements can also greatly increase blood levels here, the same period of 7-10 days should be observed before testing

Gille, D

Chronic treatment requirements further complicate therapy, particularly in elderly patients with multiple comorbidities who are highly susceptible to adverse drug reactions and drugdrug interactions (Singh et al., 2024)

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