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Moderately low serum B12 concentrations between 148 or 150 and 221pmol/L or 260pmol/L are often considered indicative of depleted or subclinical B12 deficiency

Anyone with metabolic, cardiac, GI, hepatic, or renal disease or who is pregnant, breastfeeding, or planning pregnancy should not consider it without licensed clinical care

If the symptoms of vitamin B12 deficiency are not evident earlier because of the folate intake, the effects may become irreversible

The four most common reasons are: pernicious anaemia (an autoimmune disorder of a lack of red blood cells due to the body not being to absorb enough vitamin B12) a vegetarian or vegan diet