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The USDA Agricultural Research Service used the 148 pmol/L threshold in their national prevalence studies, and the NIH Office of Dietary Supplements acknowledges that lab reference ranges can vary between institutions

If you have a vitamin B12 deficiency, you might feel symptoms like fatigue, weakness, or tingling in your hands and feet

[DOI] [PMC free article] [PubMed] [Google Scholar] 138.Tarrag, M

How quickly you respond depends on: How low your B12 levels are How long symptoms have been present Your overall health Whether there are underlying absorption problems Whether repeat treatment is needed It is important to have realistic expectations

United States Pharmacopeial Convention

The DAC version requires 1,000 to 2,000 mcg once or twice weekly