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According to the NIH Office of Dietary Supplements, functional B12 deficiency is most commonly seen in patients with one or more of the following: Age over 50 stomach acid production declines with age, and stomach acid is required to free B12 from food PPI or H2 blocker use reflux medications suppress the acid needed for B12 absorption Metformin use, which interferes with B12 absorption directly Vegan or vegetarian diets B12 is found almost exclusively in animal products Gut conditions including celiac, IBS, SIBO, and Crohns MTHFR mutations that affect how B12 is metabolized once absorbed Heavy alcohol use The symptoms of low B12 are easy to dismiss: fatigue, brain fog, low mood, tingling in the hands or feet, weakness, and shortness of breath on mild exertion

These amounts are considered safe because the human body, as a general matter, can safely store from 1,000 to 2,000 times the RDA, without negative consequence (anything more will generally be excreted in urine, per NCBI Bookshelf)

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Pulmonary embolism is a life-threatening complication of DVT

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These treatments may be incorporated into broader wellness plans when clinically appropriate