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B12 supplementation is necessary or strongly advisable in the following situations: Confirmed B12 deficiency on blood testing Vegan dietary pattern (supplements are non-negotiable) Vegetarian dietary pattern with limited dairy and egg intake Age over 50 (particularly those with reduced stomach acid) Pernicious anemia (requires B12 injections or very high-dose oral supplementation dietary sources are ineffective) Following gastric bypass or other gastrointestinal surgery affecting B12 absorption Long-term use of metformin (discuss monitoring and supplementation with your prescribing physician) Long-term use of proton pump inhibitors or H2 blockers Malabsorption conditions (Crohns disease, celiac disease, SIBO) Pregnancy or breastfeeding in women with restricted diets Exclusively breastfed infants of B12-deficient or vegan mothers Forms of B12 supplements: Cyanocobalamin is the most stable and most widely researched form of B12 supplement , and is the form recommended by most health authorities for general supplementation

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