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Vitamin B12 does require the initial loading dose period, especially in very deficient cats, so improvements will not be immediate

Absorption is also a problem in people with digestive disorders such as Celiac or Crohns disease

Deficiency after gastric banding is therefore primarily related to: Reduced dietary intake and food tolerance , limiting consumption of B12-rich foods Use of acid-suppressing medicines (PPIs or H2RAs) , which can impair the release of B12 from food proteins and reduce absorption of food-bound B12 Crystalline B12 the form found in supplements and fortified foods does not require acid or pepsin for release

Injection frequency is adjusted based on symptoms, labs, and lifestyle needs

Depletion of serum holotranscobalamin