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People with B12 levels below 200 pg/mL are called B12 deficient and are likely to have symptoms - this could be due to medicines, strict vegetarian diets, or medical conditions

That is the entire point of the fragment design

This is useful in some cases

Age Older individuals may take longer to notice benefits due to decreased absorption and metabolic rates

Vitamin B12 injections have surged in popularity due to widespread med spa marketing and wellness influencer promotion, but genuine B12 deficiency remains a real and often underdiagnosed condition particularly among older adults

Cyanocobalamin is distributed into breast milk in amounts similar to those in maternal plasma, and distribution in breast milk allows for adequate intakes of cyanocobalamin by breast-feeding infants