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Compounded Methylcobalamin injections are prepared outside the FDA approval process and are not reviewed by the FDA for safety, effectiveness, or quality

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Inadequate secretion of intrinsic factor, resulting from lesions that destroy the gastric mucosa (which can be caused by ingestion of corrosives, extensive tumors, and conditions associated with gastric atrophy, such as multiple sclerosis, certain endocrine disorders, iron deficiency, and subtotal gastrectomy) Structural lesions leading to vitamin B 12 deficiency, including regional ileitis, ileal reactions, and malignancies Competition for vitamin B 12 by intestinal parasites or bacteria

The Vegetarian Resource Group suggests that vegans need to have reliable sources of vitamin B12 in their diets.1 The Vegetarian Nutrition Dietetic Practice Group (VNDPG) of the Academy of Nutrition and Dietetics (the Academy) says that all vegetarians (including vegans) should include a reliable B12 source in their diets, such as fortified foods or supplements.2 And The Vegan Society goes so far as to state, What every vegan should know about B12: the only reliable sources of B12 are foods fortified with B12 and supplements.3 Its extremely important for health care professionalsas well as clientsto understand the significance and intricacies of sufficient vitamin B12 intake for vegan diets, because deficiency of this essential micronutrient is serious business