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Malabsorption Issues : If you have conditions like pernicious anemia, Crohns disease, or have had weight loss surgery, vitamin B12 injections may be a more effective option due to the bodys difficulty absorbing B12 through the digestive tract

Approximately one year later, he experienced a severe worsening of his previously very mild neuropathy, and lab evaluation yielded a serum B12 of 220 pmol/l (which is normal, remember!?), but an elevated serum MMA of 1300 nmol/l, supporting the existence of true B12 deficiency

Consider supplementation in asymptomatic patients with risk factors (see Table 2: Patient Risk Factors Associated with Folate Deficiency below) consider supplementation