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Injections are particularly appropriate for those with: Pernicious anaemia, an autoimmune condition affecting B12 absorption Conditions affecting the stomach or small intestine, such as Crohns disease or coeliac disease Those who have had gastric surgery or bariatric procedures Strict vegans and vegetarians not meeting their B12 needs through food or oral supplements For those who can absorb B12 normally, oral supplements are generally an effective and well-evidenced alternative to injections

coli, Haemophilus, Mycoplasma, Pasteurella, Rickettsia, Salmonella, Staphylococcus and Streptococcus spp

Guide for the Care and Use of Laboratory Animals , 8th ed, 220 (National Academies Press, 2011)

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Tell your clinician about any personal or family history of optic nerve disease before starting treatment