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Storage guidelines differ between multi-dose pens and single-dose devices , and it's important to understand which type of device you're using

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It is especially common in older individuals, occurring in more than 20% of the elderly population (Vitamin B12 (cobalamin) deficiency in elderly patients)

Nutrient Absorption Diseases Similarly, the presence of conditions, such as Crohns disease, Celiac disease, or lactose intolerance, limits the amount of B-12 absorbed into the body

Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity