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This is a serious risk

Liver Support and Detoxification Enhancement The liver processes over 80% of ingested toxins while regulating fat metabolism

Higher-Caution Situations Extra medical supervision is important if you: have a history of reactions to injectable vitamins/cobalamins have significant kidney or liver disease are pregnant or breastfeeding are offered a compounded MIC B12 product without clear labeling of ingredients, concentrations, and compounding source The FDAs overview of compounding helps explain why quality can vary (see Compounding and the FDA: Questions and Answers )

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Current attempts such as the CobaSorb Test and tests employing a detectable non-radioactive form of B12 may prove to be reasonable alternatives for the original Schillings Test, and thereby help to solve the most important question: Will this patient need a lifelong treatment with pharmacological doses of B12

This can include decreased stomach acid, which affects absorption, and diets low in animal products or high in processed food