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Fermented foods (such as tempeh), nori, spirulina, chlorella algae, and unfortified nutritional yeast cannot be relied upon as adequate or practical sources of B-12.39,40 Vegans must regularly consume reliable sourcesmeaning B-12 fortified foods or B-12 containing supplementsor they could become deficient, as shown in case studies of vegan infants, children, and adults

Patients reporting "significant energy improvement" rate injections as worth the cost at 2.4x the rate of those reporting "mild improvement." Comparison to alternatives: MIC B12 injections occupy a middle ground: more effective than oral supplementation for B12 repletion and subjective energy, less effective than prescription weight-loss medications for weight reduction, and significantly less expensive than GLP-1 agonists

In another study, choline was shown to speed up weight loss in female athletes [9]

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