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Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team

M.HashimotoK.SatohK.KanamotoT.et al (2011)

To use these injections : Benefits of Methylcobalamin, Thiamine HCI, Pyridoxine HCI, Niacinamide, D-Panthenol Injection, and Nicotinamide Injection: Vitamin B12 deficiency treatment : Methylcobalamin, a form of vitamin B12, is essential for the formation of red blood cells, maintenance of the nervous system, and DNA synthesis

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