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NICE Clinical Knowledge Summaries recommend B12 injections for: Pernicious anaemia an autoimmune condition affecting intrinsic factor production Malabsorption syndromes including coeliac disease and inflammatory bowel disease Post-surgical states particularly following gastrectomy or ileal resection Strict vegan diets when oral supplementation proves inadequate, though oral cyanocobalamin is usually sufficient for dietary deficiency Clinical trials demonstrate that B12 injections rapidly improve haematological parameters and neurological symptoms when deficiency is confirmed through blood tests

Impairment of vitamin B 12 absorption can cause megaloblastic anemia and neurologic disorders in deficient subjects

10.1016/S0968-0896(02)00163-3 46 HerfindalB.GerdtsE.KringelandE

A vegetarian diet which contains no animal products (including milk products or eggs) does not supply any vitamin B12