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For extended backcountry trips, consider timing your injection so it falls before departure or after return

Your provider can guide you on how to schedule your medications

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

The other was my inability to provide any degree of evidence outside of the safe and effective talking point to a friend who chose not to vaccinate her children and defended her stance with actual science

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