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2 North Carolina legislators have recognized the important contributions of pharmacists to patient access and quality of care and passed innovative legislation in 2021 and 2025 to capitalize on their skills in medication optimization

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Important safety considerations include: Inform your GP about all supplements you are taking Avoid self-treating suspected deficiency without medical assessment, as supplementation can mask underlying pernicious anaemia whilst allowing neurological damage to progress Do not start high-dose folic acid supplements before B12 deficiency is excluded, as this can worsen neurological damage Check for interactions if taking medications such as metformin, chloramphenicol, or proton pump inhibitors Monitor response through appropriate blood tests if treating deficiency Pregnant women, individuals with Leber's disease (a rare hereditary eye condition), and those with cobalt allergy should consult healthcare professionals before supplementing

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Sadly, some people have trouble absorbing an appropriate quantity of vitamin 12 as their bodies do not create enough stomach acid owing to autoimmune atrophic gastritis, a disorder that can induce a vitamin B12 deficiency

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