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Other factors that could lead to B12 deficiency are: Lack of adequate production of the intrinsic factor needed for B12 absorption B12 deficiency is common in elderly people as absorption of the vitamin reduces with age People who have had any intestinal surgery, such as that for weight loss Those with gut conditions such as Crohn's Disease, inflammatory bowel disease, or celiac disease SLIDESHOW See Slideshow Vitamin B12 injections Vitamin B12 supplements are given based on the condition that causes deficiency

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Healthcare providers might prescribe such a high dose to correct a deficiency, but it is too much to take without medical supervision

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Response: We believe the requirements we are finalizing in this final rule with comment period will strengthen HPT through further standardization and comparability of the allowed amounts across hospitals, and that the benefits to the public outweigh the burden on hospitals