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These people include: Elderly Adults with Atrophic Gastritis People with Pernicious Anemia Vegans & Vegetarians Pregnant & Lactating Women Particularly those who are vegan as well People Taking Certain Medications Prilosec Prevacid Metformin Tagamet Pepcid Zantac Chloromycetin Anticonvulsants More so, vitamin B12 deficiency can lead to vitamin B12 deficiency anemia, which has a range of negative symptoms: Pale or yellow skin Feelings of dizziness No appetite Rapid weight loss Numb or tingling feet Chest pain Rapid heartbeat Weak muscles Mood changes Confusion Forgetfulness More so, a long-term deficiency in vitamin B12 can lead to heart, brain, nerves, bone, and other organ damage

doi:10.1161/ATVBAHA.109.190405 Nissen, S

Heres where things get tricky (and a little frustrating)

Shah, V

After one week without adverse effects, many progress to 0.5 mg daily