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If you are supplementing and continue to show signs of deficiency, ask your doctor to test you for a condition known as pernicious anemia

Acute symptoms such as fatigue may improve relatively quickly, whereas neurological symptoms like paraesthesia (pins and needles) or cognitive difficulties typically require longer treatment courses

NHS laboratories generally define deficiency as a serum B12 below approximately 148 pmol/L (equivalent to roughly 200 ng/L or pg/mL), though reference ranges vary between laboratories and results should always be interpreted in the context of local ranges and the patient's clinical presentation

Fast Facts B12 injections can be more effective than pills in certain patients who have trouble absorbing vitamin B12