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Summary: B12 deficiency may be caused by malabsorption, poor dietary intake and/or pernicious anemia

What should the patient do if symptoms worsen

A series of recent studies implicated sirtuins as potent negative regulators of fibroblast activation and myofibroblast differentiation, and sirtuin dysfunction has been linked to the pathogenesis of SSc and other fibro-inflammatory conditions 28,29,38,39,40,41,42
Vitamin B12 Injection Dosage For Adults: A Comprehensive Guide

Safety, tolerability and pharmacokinetics of PL 14736, a novel agent for treatment of ulcerative colitis, in healthy male volunteers