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Implications in practice As there is no apparent clinical significance, the treatment should depend on the patients condition

Other factors that could lead to B12 deficiency are: Lack of adequate production of the intrinsic factor needed for B12 absorption B12 deficiency is common in elderly people as absorption of the vitamin reduces with age People who have had any intestinal surgery, such as that for weight loss Those with gut conditions such as Crohn's Disease, inflammatory bowel disease, or celiac disease SLIDESHOW See Slideshow Vitamin B12 injections Vitamin B12 supplements are given based on the condition that causes deficiency

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My clinical hierarchy in practice: address sleep, nutrition, and protein quality first

When detected, a B12 deficiency is usually treated with vitamin B12 injections or B12 supplements

Renal Dosing There are no defined guidelines for patients with renal impairment