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Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team

Chloramphenicol can antagonize the hematopoietic response to Methylcobalamin, vitamin B12 through interference with erythrocyte maturation

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Be sure to inform your provider about any medications, supplements, or health conditions you have, especially if you are managing anemia or other blood-related concerns