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High-Risk Profiles The threshold for testing should be lower if the individual falls into any of these categories: Age 60 or older Long-term use of metformin or proton pump inhibitors (PPIs) Strict vegetarian or vegan diet Family history of pernicious anemia or autoimmune disease Key Clinical Symptoms Neurological and cognitive: tingling, numbness, or a "pins and needles" sensation in the hands or feet

Additional weight loss of 5-15% of current body weight has been reported in these studies, though results vary considerably and most studies have limited follow-up duration

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Can I take a B12 pill instead of getting shots

Animal absorption does not establish human bioavailability, effectiveness or safety