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Since vitamin B 12 deficiency can cause an anemic state in the body by attenuating the immune system, patients with vitamin B 12 deficiency are more susceptible to opportunistic infections such as candidiasis [29]

Nicotinamide N-methyl transferase (NNMT)

As a result, this can mean they need to have a Vitamin B12 supplement such as a Vitamin B12 tablet or even have Vitamin B12 injections to help boost their levels

Start at the lower end

However, they are challenging to bill

There are no other absolute contraindications reported for hydroxocobalamin use in deficiency states, but caution is advised in individuals with conditions such as early Lebers optic neuropathy (a rare hereditary optic atrophy) due to the theoretical risk of worsening vision