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J Immunol (2003) 170:43844

[DOI] [PMC free article] [PubMed] [Google Scholar] 18.Bourrier M., Ferguson T.W., Embil J.M., Rigatto C., Komenda P., Tangri N

Common causes include: Pernicious anemia, an autoimmune disorder hindering Vitamin B12 absorption Gastrointestinal surgeries, like gastrectomy, impact Vitamin B12 uptake Long-term use of certain medications, such as metformin or proton pump inhibitors Diets lacking in Vitamin B12, often seen in vegans and vegetarians For those without a deficiency, Vitamin B12 injections are not typically recommended, as their body can naturally regulate and excrete excess amounts of the vitamin

The recovery or cessation process can be a difficult one

We believe this is a main reason for the reports of painful treatments