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Certain diseases eg Crohns and Coeliac disease and other diseases can cause B12 deficiency Abuse of Nitrous Oxide ( laughing gas ) Infestation of fish tapeworm ( different to meat tapeworm) caused by eating raw or insufficiently smoked fish The elderly can also be vulnerable to B12 deficiency because as they age,they produce less stomach acid , which is vital to the absorption of B12

However, that does not mean you should not, at the very least, not with the permission or direction of a physician or other health professional

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Addressing deficiencies early prevents long-term complications