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Everything here comes from published preclinical and clinical research and is not medical advice or a treatment recommendation

Groups at higher risk of deficiency include older adults (due to reduced stomach acid production), people following vegan or strict vegetarian diets (as B12 is naturally found almost exclusively in animal products), individuals with pernicious anaemia or other malabsorption conditions, those taking certain medications such as metformin or proton pump inhibitors long-term, and people with significant nitrous oxide exposure (including recreational use), which can inactivate B12 in the body

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Rationale for a multi-factorial approach for the reversal of cognitive decline in Alzheimers disease and MCI: a review

Employee Assistance Programs (EAPs) Some employers provide limited coverage for couples counseling through Employee Assistance Programs