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Certain populations are at higher risk of vitamin B12 deficiency, including older adults (due to reduced gastric acid production), individuals following strict vegan or vegetarian diets, those with pernicious anaemia (an autoimmune condition affecting intrinsic factor production), patients who have undergone gastric or ileal surgery (including bariatric procedures), and those taking medications that affect gastric acid secretion (such as proton pump inhibitors or H2 antagonists) or intestinal absorption (including metformin)

M., Patel, R., & George, R

A helpful clinical stance comes from the American Gastroenterological Associations guidance

Those who are unable to absorb an adequate amount of B12 due to dietary restrictions or health problems may need to get a natural supplement through a B12 shot

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