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Because they are soluble in water, excess B vitamins are generally readily excreted, although individual absorption, use and metabolism may vary. The elderly and athletes may need to supplement their intake of B12 and other B vitamins due to problems in absorption and increased needs for energy production. In cases of severe deficiency, B vitamins, especially B12, may also be delivered by injection to reverse deficiencies. Both type 1 and type 2 diabetics may also be advised to supplement thiamine based on high prevalence of low plasma thiamine concentration and increased thiamine clearance associated with diabetes. Also, Vitamin B9 (folic acid) deficiency in early embryo development has been linked to neural tube defects. Thus, women planning to become pregnant are usually encouraged to increase daily dietary folic acid intake and/or take a supplement.