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This is vital for people with absorption issues or at risk of deficiency

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This guideline was widely recommended in Germany (Herrmann and Obeid, 2008) for the diagnosis of vitamin B 12 deficiency in risk groups including infants, unexplained anemia, unexplained neuropsychiatric symptoms, gastrointestinal conditions including stomatitis, anorexia and diarrhea, the elderly, vegetarians and individuals with gastrointestinal diseases such as ilium resection, chronic atrophic gastritis, Crohn's disease and Helicobacter pylori infection and individuals under treatment with proton-pump inhibitors (Herrmann and Obeid, 2008

In some parts of the world, they consider it ok to have levels as low as 200 to be ok and others consider anything under 500 to be a blatant deficiency