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Additionally, chronic use of certain medications as well as periods of intense stress can reduce the stores of vitamin B12 within the body

They may contain contaminants, have lower purity, and lack sterility testing

Scientific Classification A copper-binding tripeptide composed of glycine, histidine, and lysine, supplied as the copper(II) complex

In my own practice, especially if an older person has risk factors for vitamin B12 deficiency, I consider a vitamin B12 level of 200-400 pg/mL borderline, and I usually order a methylmalonic acid level as a follow-up

These patients may only need a handful of injections to restore their B12 levels, which can then be maintained with a high-dose supplement or scheduled injections

Slowed gastric emptying Explored in research on how delayed gastric emptying prolongs fullness and may reduce overall calorie intake