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Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

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Conditions like celiac disease, inflammatory bowel disease, gastric surgeries, or chronic use of certain medications can reduce absorption from food and pills. If you have ongoing digestive issues, your provider may recommend a combination of gutsupporting strategiessuch as probiotics, a balanced diet, or targeted therapiesalong with B12, often using injections to bypass the digestive tract altogether

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It also plays a significant role in metabolism and helps your body break down fats and meals