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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

Vitamin injections at Sacramento Naturopathic Medical Center are given via a small subcutaneous (under-the-skin) or intramuscular injection

Theyre commonly used as a support tool, but research on direct weight-loss effects is limited

Another issue is pain