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The solvent Another possible cause of painful B12 injections is the solvent used to dissolve the B12 in the vial

The extreme version, from the pure carnivore diet types, is that plants are trying to kill us

A meta-analysis of four observational studies, following a total of 7,475 older individuals for 3 to 16 years, found a weak association between an elevation in vitamin B 12 of 50 pmol/L in blood and a reduction in fracture risk (114)

Particularly for those with a family history or genetic predisposition (like APOE4 carriers for AD), microbiome-based prevention could be an attractive low-risk strategy to reduce risk or delay onset