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Older adults over the age of 60 because the stomach lining produces less stomach acid as we age which is needed to absorb B12

It also helps with weight loss by boosting energy to work out harder

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Intramuscular hydroxocobalamin injections are the recommended first-line treatment in the UK, as they bypass the absorption problem caused by lack of intrinsic factor

Conditions include alcoholic liver disease, viral hepatitis, cirrhosis, and primary or metastatic liver cancer Renal dysfunction : Impaired kidney function reduces B12 elimination, causing accumulation even with normal intake Haematological conditions : Myeloproliferative neoplasms, chronic myeloid leukaemia, polycythaemia vera, and hypereosinophilic syndrome increase transcobalamin production, elevating total serum B12 Laboratory interference : Macro-B12 (immunoglobulin-bound B12) and assay interference can cause spuriously elevated results without true excess In clinical practice, unexplained hypercobalaminaemia should prompt investigation for underlying disease, particularly in patients without obvious supplementation history

Most people start to see some changes in weight after the first month