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Some high risk groups for vitamin B12 deficiency include: elderly people- often stomach acid production decreases with age individuals who have had intestinal surgery such as weight loss surgery or laparoscopies individuals with GI issues including celiac disease, IBD, IBS (MOST OF YOU!!!) those following a vegetarian or vegan diet- due to the lack of animal protein eaten (one of the main sources of B12) individuals with pernicious anemia- do not make intrinsic factor Notice how a fair amount of the high risk individuals are those with some sort of intestinal issue

A clinician may evaluate: The goal is to choose the treatment strategy that best matches the patients labs, symptoms, and future plans

Advantage of PAE over Surgery Less risk of sexual side effects, such as retrograde ejaculation Lower risk of incontinence Less likely to require urinary catheterization Less downtime with fast recovery Minimally invasive without large incisions Safe and effective alternative to surgery More than 3 out of 4 men avoid TURP surgery Can serve as a bridge between medical therapy and surgery Surgical options such as TURP and open prostatectomy have higher reported rates of retrograde ejaculation (ejaculation into the bladder rather than out through the urethra), impotence, and urinary incontinence

Product: Hydroxocobalamin Injection 30,000 mcg, 30 mL, Multidose Vial