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Other factors include: Underlying cause of deficiency : Pernicious anaemia, malabsorption disorders, or dietary insufficiency may affect treatment response Medication use : Metformin and proton pump inhibitors can reduce gastrointestinal B12 absorption (though this does not affect the efficacy of intramuscular injections) Individual variation : Differences in how efficiently your body utilises the injected vitamin Adherence to treatment schedule : Missing injections or delaying maintenance doses can slow recovery Discussing these factors with your healthcare provider helps set realistic expectations for your treatment journey
doi:10.1016/S0736-0266(03)00110-4 Goldstein AL, Hannappel E, Sosne G, Kleinman HK
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Clinical Trials: Impact of B12 Supplementation on Metabolites Below are four graphs showing the response to B12 supplementation of serum B12, holotranscobalamin, MMA, and homocysteine: Eight trials of predominantly older adults with at least mild deficiency (Dangour, 2015
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