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Critical risk factors include: Pre-existing B12 deficiency, which accelerates depletion and compounds neurological damage Chronic exposure through recreational use or occupational contact, leading to severe neurological outcomes Older-adult factors, especially in those over 50, due to reduced intrinsic factor production If youre vegan, vegetarian, or taking medications like metformin or acid reducers, youll need vigilant monitoring

doi: 10.1111/j.1471-4159.2011.07189.x

[DOI] [PMC free article] [PubMed] [Google Scholar] 55.Levine BL et al