It is used in the treatment and prevention of vitamin B12 deficiency in patients with conditions such as:_ Addisonian (pernicious) anemia Malabsorption Atrophic gastritis Prolonged treatment with metformin Small bowel bacterial overgrowth (SIBO) Total or partial gastrectomy Infection with the fish parasite Diphyllobothrium latum Helicobacter pylori infection Pancreatic dysfunction Pancreatic or bowel malignancy Dietary deficiency (e.g
Every lot is independently tested for identity, purity, and content, with a lot-specific Certificate of Analysis available for review
Strength points and limitations Based on our knowledge, this is the most updated meta-analysis on this topic, including all available evidence based on our inclusion criteria of including only controlled studies, either RCTs or controlled observational studies, to reach the highest accessible quality of evidence from the available evidence found in the literature
Alternative therapy, such as hydroxocobalamin, is advised
Deficiencies can occur due to low feed intakes or more commonly as a result of vitamin breakdown by oxidation during the processing and storage of grains and hays
