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Rare hypersensitivity reactions , including cobalt allergy (as cobalamin contains cobalt), have been documented

If you are using a compounded product and you were not told it contains B12, but the liquid is pink, contact your pharmacy immediately to confirm the formulation

Medical Conditions, Surgeries, and Medications Lack of intrinsic factor (a protein made in the stomach thats needed for B12 absorption) - this condition is called pernicious anemia Thyroid disease HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) Autoimmune diseases like type 1 diabetes, where the immune system in the body attacks its own tissues Gastric bypass surgery (weight loss surgery) Chronic gastritis surgery Certain medications like heartburn drugs (proton pump inhibitors) which reduce stomach acid production Who Is At Risk of Vitamin B12 Deficiency

However, many people with fatty liver have other risk factorssuch as metformin use, proton pump inhibitors, or dietary restrictionsthat can independently lead to B12 deficiency, making monitoring important when symptoms or risk factors are present