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Many people will also experience cognitive difficulties such as problems with vision, memory, thinking, or reasoning, the development of mental illnesses such as depression, or general changes in behavior

Indications and Usage for B!2 Inject Kit Cyanocobalamin is indicated for vitamin B 12 deficiencies due to malabsorption which may be associated with the following conditions: Addisonian (pernicious) anemia Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy Fish tapeworm infestation Malignancy of pancreas or bowel Folic acid deficiency It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see Drug Interactions), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue

They cited Pyo et al

People with Alcohol Dependence: Chronic alcohol consumption can impair B12 absorption and lead to deficiency