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Medical Conditions, Surgeries, and Medications Lack of intrinsic factor (a protein made in the stomach thats needed for B12 absorption) - this condition is called pernicious anemia Thyroid disease HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) Autoimmune diseases like type 1 diabetes, where the immune system in the body attacks its own tissues Gastric bypass surgery (weight loss surgery) Chronic gastritis surgery Certain medications like heartburn drugs (proton pump inhibitors) which reduce stomach acid production Who Is At Risk of Vitamin B12 Deficiency

People with low B12 levels often experience irritability and depression

It is especially beneficial for individuals with dietary restrictions, gastrointestinal issues, or higher nutritional demands

Based on 50 units SQ once every 5 days

We note that the numbers provided in this column isolate the estimated effect of this final policy adjustment relative to the numerator of Column 4