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A WHO consultation identified the most vulnerable groups as elderly individuals, infants, preschool-aged children, and pregnant or lactating women, due to either increased nutritional demands or impaired absorption capacity (de Benoist, 2008)

Additionally, HCG is contraindicated in cases of precocious puberty, as it may exacerbate early sexual development, especially in prepubertal males receiving it for cryptorchidism

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Handling should be done only by trained professionals in appropriately equipped facilities

In people over 60, the prevalence is around 2%.[ref] The lack of vitamin B12, though, can cause symptoms long before developing pernicious anemia