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Acknowledgements The authors would like to thank Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou Institute of Systems Medicine and the Department of Infectious Disease, the First Affiliated Hospital of Anhui Medical University for its support

At Gameday Mens Health, these injections are offered as part of a personalized wellness plan designed to help you optimize your health and reach your fitness goals with confidence

If oral supplements are not sufficient or absorption is compromised, periodic B12 injections may be recommended by our healthcare providers

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The symptoms of vitamin B12 deficiency can be quite debilitating and include, according to scientific research: Chronic fatigue and weakness Shortness of breath Heart palpitations Tingling or numbness in the extremities Poor balance Loss of concentration and poor memory Disorientation Mood changes, including depression Insomnia Imagine trying to maintain a healthy, active lifestyle when you're constantly battling severe fatigue and low energy

[10] Initial assessment involves: Detailed medical history, including dietary habits and gastrointestinal symptoms Medication review (certain drugs like metformin and proton pump inhibitors can affect B12 absorption) [20] [21] Family history of pernicious anaemia or autoimmune conditions Physical examination for signs of anaemia or neurological abnormalities Laboratory investigations typically include: Serum vitamin B12 level: The primary test, though interpretation can be complex