If someone has a b12 deficiency due to alcoholism will simply quitting drinking and improving diet work to restore the levels or are supplements and shots needed? i realize this might be a "there's no clear, definite answer" kind of question.

Multivitamins: Alcoholism causes deficiency of other vitamins before depleting B12. If you are deficient in B12 as revealed by a blood test, it is likely to be due to poor absorption and you will need injections of B12. Otherwise you should a multivitamin pill with B12. For good health - Have a diet rich in fresh vegetables, fruits, whole grains, low fat milk and milk products, nuts, beans, legumes, lentils and small amounts of lean meats. Avoid saturated fats. Exercise at least 150 minutes/week and increase the intensity of exercise gradually. Do not use tobacco or alcohol in any form. Practice safe sex.

Most likely: But do note that you may need a much higher than the maintenance dose to make up for the loss. Some feel that sublingual B12 is better absorbed. I hope you will follow through on the abstinence aspect.

B-12 supplements: It is preferable to replace B-12 through both diet and supplements to the normal level as soon as possible. Then maintaining a healthy diet and eliminating alcohol consumption should be enough to maintain normal levels without supplements. B-12 deficiency left untreated can lead to permanent damage. Unless a person has pernicious anemia, supplements can be taken by mouth.

Variations matter: Deficiencies created during a chronic affliction like alcoholism vary by degree and other related or unrelated health issues. Your body requires B12 to keep its nerves healthy and produce effective blood cells, along with many other functions. Injections may be needed in the short term to stop or reverse damage.Supplements along with diet may then be adequate as you return to better health.

Great question: It is a both/and answer. That is, quitting drinking, eating health diet and B12 (and other vitamins) supplementation will restore healthier functioning.

Depends : If the B12 def was due to diet, it takes yrs to deplete liver stores. Alcohol can cause chronic gasritis. This can lead to factor R or intrinsic factor issues which despite stopping alcohol may not improve B12 absorption. Suggest get labs checked and consider high dose oral or IM B12 and also folic acid replacement.