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There are a number of medical conditions and or medicines that may affect the decision to treat

Those with liver or kidney disease might need their doses changed because these conditions can affect how B12 is processed and removed from the body

Pinpointing Absorption Issues: Testing helps us determine if your body is failing to absorb B12 from food due to gut issues, age, or autoimmune conditions like pernicious anemia

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Drug/Laboratory Test Interactions: Persons taking most antibiotics, methotrexate and pyrimethamine invalidate folic acid and vitamin B 12 diagnostic blood assays

That is actually part of why people stay with it