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As we age, our stomachs produce less acid, which makes it harder to absorb B12 from food

Genetic defects affecting B12 processing and methylation

Patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 micrograms per kg per day, accumulate aluminum at levels associated with central nervous system and bone toxicity

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Realistic expectations are 0.25-0.5 kg (0.5-1 lb) per week under optimal conditions, with the rate influenced by baseline body composition, dietary habits, activity level, and individual metabolic responsiveness

B12 shots can last in their benefits for about one to two weeks