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For vegans, fortified plant-based milks, nutritional yeast and fortified cereals can provide B12

This contrasts sharply with full-length human growth hormone, which can impair glucose tolerance and insulin sensitivity, potentially precipitating or worsening diabetes

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Food and Drug Administration) Dietary deficiency of vitamin B 12 occurring in strict vegetarians and in their breastfed infants (isolated vitamin B 12 deficiency is very rare) Malabsorption of vitamin B 12 resulting from damage to the stomach, where intrinsic factor is secreted, or damage to the ileum, where intrinsic factor facilitates vitamin B 12 absorption