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Gastrointestinal Disorders : Individuals with conditions that affect nutrient absorption, such as Crohns disease, celiac disease, or those who have had surgeries like gastric bypass, may benefit from B12 shots due to impaired absorption of vitamins from the diet

Interestingly, some clinical studies have found that individuals with vitiligo often have lower serum levels of Vitamin B12 and folic acid than healthy individuals

32-34 In a randomized placebo-controlled trial that included 112 symptomatic perimenopausal women, menopausal symptom scores as rated by the 44-point menopause rating scale (MRS) decreased by 14.6 points in those taking one 4 mg tablet of a standardized Siberian rhubarb daily for 12 weeks compared with a 3-point decrease in those taking placebo

Now I add in the GI signs, and using Clinical Reasoning the rule-out that rises to the top of my list is food allergy