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Deficiency can lead to macrocytic anaemia, neurological symptoms including peripheral neuropathy, cognitive changes, and fatigue
I bet it was already part of his agenda even before he got this letter

Amino Acids as Targets for Immunotherapy against Solid Tumors

Narasimhan P, Sklar R, Murrell M, Swanson RA, Sharp FR
Some recommendations when opening ampoules Thoroughly wash your hands before opening

For conditions where there are defective nerves, such as peripheral neuropathy, neuralgia, and Mortons neuroma or any interspace perineural neuritis, injecting a concentrated B12 dose directly around the nerve has been shown to promote nerve repair and diminish pain from nerve damage
