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While the condition is the major cause of poor vitamin B 12 status in the elderly population, it is usually associated with atrophic gastritis, a chronic inflammation of the lining of the stomach that ultimately results in the loss of glands in the stomach (atrophy) and decreased stomach acid production (see Atrophic gastritis)

Additionally many people report feeling more energetic after receiving their injections which can be beneficial when trying to combat fatigue caused by low b-vitamin levels due to poor dietary intake or malabsorption issues such as those experienced by individuals suffering from celiac or Crohns disease

Vegans have no reliable dietary b12 sources unless they consume fortified foods or supplements

Again, no firm diagnosis

People with gastrointestinal issues or pernicious anemia should take a one-milligram dose of B12 daily, in either injection or oral forms