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Drug Interactions May interact with certain antibiotics Reduced absorption with proton pump inhibitors Interaction with folic acid therapy in some cases Always inform your doctor about ongoing medications

Image source Adequate stomach acid and enzymes are required to free B12 from the proteins it is bound to in food

I recommend: at least 2,000 mcg (g) cyanocobalamin once each week, ideally as a chewable, sublingual, or liquid supplement taken on an empty stomach or at least 50 mcg daily of supplemental cyanocobalamin or a serving of B12-fortified foods three times a day, each containing at least 190 percent of the Daily Value listed on the nutrition facts label Those over 65 years of age should take at least 1,000 mcg (g) cyanocobalamin every day

A provider screens your history, watches for any reaction, and adjusts or stops if needed