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Some high risk groups for vitamin B12 deficiency include: elderly people- often stomach acid production decreases with age individuals who have had intestinal surgery such as weight loss surgery or laparoscopies individuals with GI issues including celiac disease, IBD, IBS (MOST OF YOU!!!) those following a vegetarian or vegan diet- due to the lack of animal protein eaten (one of the main sources of B12) individuals with pernicious anemia- do not make intrinsic factor Notice how a fair amount of the high risk individuals are those with some sort of intestinal issue

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Occur in 3050% of subjects during dose titration