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If you have any concerns or questions regarding the usage or effects of this medication, do not hesitate to consult with your doctor for guidance

However, always consult with your OB-GYN or midwife before starting any new supplement, particularly at higher-than-recommended doses

So people at greatest risk for deficiency include those with low stomach acid (e.g., older adults and people on proton pump inhibitors or antacids) or low IF production (known as pernicious anemia), people on medications that interfere with B12 absorption (such as metformin), people who have had gastric surgery, those with GI conditions that impair nutrient absorption (like celiac or Crohn's disease), and people on vegan and vegetarian diets

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Before filling, each vial is properly washed, sterilized and dried

At high doses one or more of its phase 1 metabolites destroys hematological stem cells and can cause death due to the failure to produce red blood cells, white blood cells, and platelets