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Vitamin B12 deficiency can be occurring while vitamin B12 levels are at levels not typically associated with deficiency due to the presence of deleterious MTHFR mutations. 5 If you have one or more MTHFR, MTRR or MTR gene mutations, you will be less able to methylate B12 or convert your B12 to methylcobalamin

Colchicine, Neomycin, Aminosalicylic Acid, H2-blockers (e.g., Ranitidine), and Proton Pump Inhibitors (PPIs, e.g., Omeprazole): These oral medications can all interfere with the intestinal absorption of dietary B12, making the need for injectable B12 more pronounced

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