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So people at greatest risk for deficiency include those with low stomach acid (e.g., older adults and people on proton pump inhibitors or antacids) or low IF production (known as pernicious anemia), people on medications that interfere with B12 absorption (such as metformin), people who have had gastric surgery, those with GI conditions that impair nutrient absorption (like celiac or Crohn's disease), and people on vegan and vegetarian diets

However, always consult with your OB-GYN or midwife before starting any new supplement, particularly at higher-than-recommended doses

Before filling, each vial is properly washed, sterilized and dried