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Vitamin B12 deficiency and use of proton pump inhibitors: a systematic review and meta-analysis

Symptoms of a B12 Deficiency Initially, the symptoms of B12 deficiency can be difficult to notice

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Cautious use of parenteral cyanocobalamin is also recommended in patients with renal impairment, including premature neonates, because of the possibility of greater aluminum accumulation, which may cause central nervous system and bone toxicity

Laboratories and manufacturing facilities that make the injections are certified by globally recognized institutions such as the US Food and Drug Administration (FDA)

Symptoms often develop gradually, making them easy to dismiss