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Patients commonly report: Persistent fatigue and weakness Breathlessness, particularly on exertion Palpitations Pale or jaundiced skin These symptoms reflect the development of megaloblastic anaemia, where red blood cells become abnormally large and dysfunctional

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This can happen due to various reasons such as poor diet, absorption issues, or certain medical conditions

People at risk of a vitamin B12 deficiency usually have conditions that hinder the absorption of B12 from their gastrointestinal system

However, injections require clinic visits and professional administration, increasing treatment costs

Specifically, this effect is mediated through an increase in butyrate-producing bacteria (such as FP , Roseburia , Butyricicoccus porcorum , and Gemmiger formicilis ) and a decrease in conditionally pathogenic bacteria (including Akkermansia and Parasutterella excrementihominis )