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Individuals with Gastrointestinal Disorders: Such as Crohns disease, celiac disease, atrophic gastritis, or those who have had gastric bypass surgery or other stomach/intestinal resections, which can interfere with B12 absorption

Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors (4, 5.1)

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In a 2023 study , researchers found no connection with low B12 levels and erectile dysfunction, contrary to the general trend in the medical literature

Patients with unstable cardiovascular disease, poorly controlled hypertension, or significant hypotension may require additional monitoring or alternative therapies