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You are a Vegetarian or Vegan Since the primary dietary sources of B12 come from animal products, strict vegetarians and vegans are at very high risk of developing a B12 deficiency

[2] [1] With neurological involvement: Hydroxocobalamin 1mg intramuscularly on alternate days until no further improvement, then maintenance injections every 2 months

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People with Certain Medications Long-term use of certain medications, like proton pump inhibitors, H2 receptor antagonists, or metformin, can interfere with B12 absorption

Fluid retention might diminish the effect of antihypertensive drugs

Cyanocobalamin (B12): Supports energy production, nerve function, and red blood cell formation