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Vitamin B12 deficiency can also be found in people with poor nutrition, pernicious anemia, infection, cancer, surgery, alcohol, medications (PPIs or other acid-suppressing drugs), exposure to nitrous oxide (during surgery or recreational use), stomach/intestinal problems such as intestinal dysbiosis, leaky gut or gut inflammation, atrophic gastritis or hypochlorhydria (low stomach acid) and/or nerve damage

It is not a drug, dietary supplement, food, or cosmetic and has not been approved by the U.S

Stopping criteria: Height velocity below 4 cm/year at any mid-pubertal assessment

Ramanjaneya, M

This deficiency can also be prevalent in heavy smokers and drinkers