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Its a two-way street in IBD, with the gut microbiome changes potentially causing high homocysteine, but then high homocysteine will increase the inflammation in the gut.[ref] Gastrointestinal production of homocysteine: Gut microbes that produce folate: The amount of folate produced by the gut microbiome is on a similar scale to what we get from food, so it is a significant source of folate for most people

With your other hand, grasp the skin where you plan to inject the medicine

Oxford Open Immunol

[1] Don't purchase over-the-counter B12 supplements without medical guidance, as this can interfere with accurate assessment and may mask underlying conditions