In some cases, it can lead to vision impairment, including blindness, if left untreated
Since multiple species of Propionibacterium produce no exotoxins or endotoxins and have been granted GRAS status (generally regarded as safe) by the United States Food and Drug Administration, they are the preferred bacterial fermentation organisms for vitamin B 12 production
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Veterinarians may choose injections when deficiency is significant or absorption is compromised, and injectable hydroxocobalamin has been used effectively in cats with GI-related deficiency(Kook PH, 2020)
Older adults, in particular, struggle to recover when they experience any vitamin deficiency
