Vegans, vegetarians, people over the age 50, anyone with stomach/bowel issues like chronic gastritis, leaky gut, IBS or celiac, and anyone who regularly takes medications such as Metformin, PPIs (used for GERD), H2 Receptor Antagonists (used for peptic ulcers), or anything that interferes with stomach acid production are actually at risk for vitamin B12 deficiency, and should supplement B12 regularly
If refills are included, you can contact the compounding pharmacy directly to set up your billing and shipping
For the subset of patients requiring neurology collaboration (skin biopsy for SFN, complex medication-induced neuropathy), we coordinate directly
Daily injections at the beginning are key for: Quickly fixing the deficiency Reducing severe symptoms Getting ready for ongoing treatment Secondary Phase: Weekly Injections for One Month After the first week, injections are given weekly for a month
A dulled needle causes more tissue damage, more pain, and creates a larger opening in the rubber stopper that accelerates coring
