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It takes several years to completely deplete your livers stores of B12, so people who have recently started a vegan or vegetarian diet may still have moderate vitamin B12 levels.[ref] Dietary sources: Foods that are highest in B12 include:[ref] beef liver mussels lamb caviar chicken livers High Homocysteine and B12: Homocysteine levels: If your homocysteine levels are high and you carry the MTHFR or MTRR reduced function variant above, supplementing with vitamin B12, methylfolate, riboflavin, and B6 may help to lower your levels.[ref][ref][ref] Interaction with alcohol: Alcohol is metabolized into acetaldehyde, which is toxic and inhibits methionine synthase (MTR)

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( 4 , 5 ) S-Acetyl Glutathione A Major Advance S-Acetyl glutathione is an active antioxidant derived from glutathione which actually turns out to be more reliable in the blood

These include: Metformin (used for diabetes or PCOS) Proton Pump Inhibitors (used for acid reflux or GERD) H2 Blockers Birth control pills Certain antibiotics If youre taking these medications long-term, particularly in combination, regular B12 injections might be beneficial

However, your provider may adjust the frequency based on your specific needs and B12 levels