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Indications and Usage for B-12 Compliance Injection Cyanocobalamin is indicated for vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions: Addisonian (pernicious) anemia Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy Fish tapeworm infestation Malignancy of pancreas or bowel Folic acid deficiency It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see DRUG INTERACTION), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue

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Excessive methionine intake in the presence of inadequate intake of folic acid , vitamin B6 , and vitamin B12 , can increase the conversion of methionine to homocysteine , a substance linked to heart disease and stroke

Manufacturers may fortify certain foods, such as cereals, with the synthetic form of vitamin B12