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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

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[92] As of 2019, nineteen countries require food fortification of wheat flour, maize flour, or rice with vitamin B 12

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All vegans should take a B12 supplement to ensure adequate B12 intake