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When I see a patient with a vitamin B12 deficiency that does not seem to match their bariatric history (or who is deficient without any bariatric procedure at all), I work through this list to find the cause

Aseptic Technique Requirements All reconstitution procedures must employ strict aseptic technique to prevent microbial contamination: Work in a clean environment, preferably within a laminar flow hood when available Clean rubber stoppers with 70% alcohol swabs before needle insertion Use sterile syringes and needles for all transfers Never touch needle tips or allow contact with non-sterile surfaces Proper Addition Method The physical method of adding solvent significantly impacts reconstitution success

Data Animal Data In pregnant rats given daily subcutaneous doses of zoledronic acid of 0.1, 0.2, or 0.4 mg/kg during organogenesis, fetal skeletal, visceral, and external malformations, increases in pre-and post-implantation loss, and decreases in viable fetuses and fetal weight were observed at 0.2 and 0.4 mg/kg/day (equivalent to 2 and 4 times the human 5 mg intravenous dose, based on AUC)

Now I see your posts and feel a bit nervous

Close attention should be paid to the adverse events of vaccinated individuals