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Injections are prescribed when dietary intake is inadequate or absorption is impaired

Cyanocobalamin is indicated for vitamin B 12 deficiencies due to malabsorption which may be associated with the following conditions: It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see Drug Interactions), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue

[21] [22] [23] [24] [25] [29] [30] Anemia may also lead to cardiac murmurs [24] [23] and/or altered blood pressure (low or high)

A portion of the supplement is lost in digestion and first-pass metabolism in the liver

Recovery of digestive tissue under stress

see Table 1) (EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2015)