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Patients with evidence of vitamin B 12 deficiency and chronic gastrointestinal symptoms such as dyspepsia, recurrent peptic ulcer disease, or diarrhea may warrant evaluation for such entities as Whipple's disease (a rare bacterial infection that impairs absorption), Zollinger-Ellison syndrome (gastrinoma causing peptic ulcer and diarrhea), or Crohn's disease

Its best when both problems are big and linked

The most important safety factor is using a medical-grade source under a provider's care rather than buying unregulated research chemicals online

2019 Jun London: National Institute for Health and Care Excellence (NICE)