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Therefore, if you have recently changed your diet, become vegan, and stopped consuming B12-rich foods, it may take several years for a deficiency to become apparent, and dietary supplementation might be an adequate solution over any need for B12 injections

TC, transcobalamin VitB12, tHcy, total ho

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18 Prevention Because of potential interactions from prolonged medication use, physicians should consider screening patients for vitamin B 12 deficiency if they have been taking proton pump inhibitors or H 2 blockers for more than 12 months, or metformin for more than four months

Escherichia coli can also produce vitamin B 12 by salvage pathway

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