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Patients receiving long-term therapy with omeprazole or other proton pump inhibitors (PPIs) should be monitored for signs of B12deficiency

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[11] Long-term metformin therapy reduces calcium-dependent intrinsic-factor binding, lowering B12 absorption and potentially necessitating higher or more frequent parenteral doses

Identification of nicotinamide N-methyltransferase as a promising therapeutic target for sarcopenia

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Some research from Germany has shown that an even higher threshold (over 500 pg/mL) is necessary in early-to-mid pregnancy to maintain vitamin B12 levels throughout pregnancy, lactation, and to support an infants vitamin B12 status (via breast milk) through 6 months of age