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People who are most at risk of being B12 insufficient or deficient are vegans, vegetarians or those who do not eat much red meat older adults, individuals with atrophic gastritis, pernicious anemia, gastrointestinal disorders, those who have had gastrointestinal surgery + people who take certain medications including, but not limited to, birth control pills, H2 receptor antagonists (such as Tagamet, Pepcid + Zantac), PPIs (Proton Pump Inhibitors, such as Prilosec or Prevacid), Chloramphenicol (Chloromycetin) + Metformin

The dosage depends on the ingredients

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However, I typically tell patients if they have gotten absolutely no benefit after the 2 nd round that we should move on to another treatment option