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After a B12 shot, blood levels rise well above the desired range (150-700 pmol/L in most places), and stay high for a while
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8,9 Table 1 Risk Factors for Vitamin B12 Deficiency A multicenter randomized controlled trial of 390 patients with diabetes mellitus showed that those taking 850 mg of metformin three times per day had an increased risk of vitamin B 12 deficiency (number needed to harm = 14 per 4.3 years) and low vitamin B 12 levels (number needed to harm = 9 per 4.3 years) vs
B12 deficiencies often lead to fatigue, weakness, and low stamina
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Additionally, chronic conditions such as HIV and tuberculosis have been implicated in B12 deficiency due to increased metabolic demand and altered absorption mechanisms ( The diagnosis of vitamin B12 deficiency typically relies on low total B12 levels and elevated concentrations of homocysteine (Hcy), as well as levels of transcobalamin-bound B12 (holoTC) and methylmalonic acid (MMA), which serve as functional indicators of cobalamin insufficiency ( Vitamin B12 requirements fluctuate throughout the life course, influenced by metabolic demand and physiological changes
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