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The absence of safety data in these populations should inform clinical decision-making and prescribing practices

Importantly, functional B12 deficiency can sometimes coexist with high total B12 levels, especially in kidney disease, and may require additional testing with methylmalonic acid (MMA) or holotranscobalamin if deficiency is suspected clinically

Food and Drug Administration for weight management or any other medical purpose

For these reasons, most specialists strongly advise patients to avoid drinking before epidural injections to minimize complications and ensure a smooth recovery

Likewise, autoimmune conditions that affect the stomach lining, such as atrophic gastritis or pernicious anemia, directly impact intrinsic factora protein essential for B12 absorption