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Because of the increased risk of food-bound vitamin B 12 malabsorption in older adults, the FNB recommended that adults over 50 years of age get most of the RDA from fortified food or vitamin B 12 -containing supplements (21)

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Many commercial preparations contain additional ingredients such as: Sorbitol or mannitol sugar alcohols used as sweeteners in some tablets that can cause osmotic diarrhoea when consumed in larger quantities, though the amounts in typical supplements are usually too small to cause symptoms alone [13] [14] Binding agents and fillers including lactose, which may cause symptoms in people with lactose intolerance, though tablet quantities are typically small Other additives various excipients that some individuals may be sensitive to The dose and frequency of supplementation may also influence tolerability