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A doctor or other healthcare provider (like a nurse practitioner) must have a face-to-face visit with you before certifying that you need home health services

Disruptions in the intrinsic factor (IF) pathway, including impaired IF production due to autoimmune conditions (pernicious anemia), damage to the ileum from diseases like Crohns or celiac disease, or surgical resection of the ileum, can severely impair B12 absorption

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Unfortunately, some patients have difficulty absorbing an adequate amount of vitamin 12 because they do not produce enough stomach acid due to a condition called autoimmune atrophic gastritis which can cause a deficiency of vitamin B12

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Allow 15 to 20 minutes for the solution to fully stabilize before drawing the first dose