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The Vegan Society and NHS recommend that vegans take B12 supplements or consume fortified foods regularly

Additionally, vitamin B 12 deficiency can also occur as a result of other malabsorptive conditions (such as inflammatory bowel disease, or pancreatic insufficiency), after certain procedures (such as bariatric surgery, or ileal resection), restricted diets (such as veganism), or the use of certain medications (such as metformin or proton-pump inhibitors)

The FDA does not review compounded medications for safety, effectiveness, or manufacturing quality prior to distribution

Amanecia does not prescribe it for cosmetic tanning