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Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

If you are getting injections for maintenance or other benefits every 1-3 months may be more appropriate

Pregnancy and Breastfeeding: B12 needs increase during these times, and injections can be beneficial

doi: 10.4239/wjd.v2.i2.19