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Both were removed from the FDA Category 2 list in April 2026 and are on the July 23 to 24, 2026 advisory agenda, but they cannot be compounded until the committee recommends them and the FDA completes rulemaking, which takes time

The rapid dietary shift from high-fiber to high-concentrate feeds during the periparturient period profoundly reshapes the rumen microbial landscape

Minimally invasive procedures, such as a needle injection under image guidance, are used to introduce the cells into the IVD

However, it is not always required for diagnosis

Conditions such as pernicious anaemia (an autoimmune condition affecting intrinsic factor production, which should be confirmed with intrinsic factor antibody testing), Crohn's disease, coeliac disease, and those who have undergone gastric surgery (including bariatric procedures) may have severely impaired B12 absorption