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People at risk of vitamin B12 deficiency include: Older adults People with diseases of the stomach or small intestine which impact your bodys ability to absorb nutrients, including celiac disease and Crohns disease People who have had gastrointestinal surgery, such as bariatric surgery for weight loss Vegans and vegetarians, since the biggest dietary sources of B12 are from animal products People taking certain medications for long periods of time, such as proton pump inhibitors, histamine 2-receptor antagonists and metformin

Chronic conditions may require 2-4 weeks before meaningful changes appear

Second, they are most common during escalation periods and tend to decrease as the body adapts

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warm slightly in hand if needed, but dont heat externally