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Those most at risk include vegans and vegetarians, people with digestive conditions such as Crohn's disease, coeliac disease or IBS, those taking long-term metformin or proton pump inhibitors, older adults whose ability to absorb B12 through the gut declines naturally with age, those with pernicious anaemia, and anyone with a history of chronic alcohol use

It reflects early biological activity at the site

Olasupo Odunsi, MD, Medical Director Reviewed July 5, 2026 Thinking about B12 shots but want to know if they actually deliver

Theres no established upper limit

We reserve them for diverticulitis in people with an abscess, a significant amount of inflammation, symptoms that aren't improving, a suppressed immune system, frailty, or other health problems - such as liver or kidney disease," Dr