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I turned around and drove home and spent the whole day on the couch

Other malabsorption causes include: Atrophic gastritis and reduced gastric acid production (common in older adults) Gastrointestinal surgery, particularly gastrectomy, ileal resection, or bariatric surgery (especially gastric bypass) Inflammatory bowel disease affecting the terminal ileum (Crohn's disease) Coeliac disease and other small bowel disorders Chronic pancreatitis affecting enzyme secretion Helicobacter pylori infection (may contribute to reduced absorption) Medication-related deficiency is increasingly recognised

Among the various options available, GLP-1 injections, lipo injections, and B12 injections stand out

The one thing not to do is stop or change a prescribed course suddenly on your own, especially where the cause is non-dietary and the treatment is lifelong

They already have minimal b12 intake