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Proton-pump inhibitors (e.g., omeprazole, esomeprazole, and lansoprazole), used to treat Zollinger-Ellison syndrome and gastroesophageal reflux disease (GERD), markedly decrease stomach acid secretion required for the release of vitamin B 12 from food but not from supplements

In addition, gene mutations in these degradation enzymes can falsify the result

This is another reason why its important to look closely at the manufacturers instructions for the product

Important limitations on this safety profile: the longest trial was 24 weeks, the total trial population is small by modern standards, and the clinical trials used oral dosing

Everyones needs are different

Experts explain these safety points in clinical guidance about B12 usage