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With food

Many people start with weekly shots, then move to monthly maintenance once levels are stable

Proton-pump inhibitors (e.g., omeprazole, esomeprazole, and lansoprazole), used to treat Zollinger-Ellison syndrome and gastroesophageal reflux disease (GERD), markedly decrease stomach acid secretion required for the release of vitamin B 12 from food but not from supplements

Frozen seafood and meats may also have added salt

Understanding what drives degradation helps you make better storage and usage decisions

This is super important for folks dealing with stuff like fatty liver cozied up with booze or other health hiccups