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A further complicating factor...when you had your gall bladder removed it is more than likely that you were given nitrous oxide as part of the anaesthetic - and nitrous oxide deactivates all vitamin B12 (this is not detectable on blood tests)

Vega-Melndez, G

Targeted degradation of LRG1 to attenuate renal fibrosis

doi: 10.1016/j.neuron.2022.03.034 213 LeeM.ShiX.BarronA

These receptors initiate receptor-mediated endocytosis and transendocytosis processes, facilitating the efficient transportation of therapeutic genes, including neuroprotective factors and enzymes, to the parenchymal cells within the brain (Huang et al., 2024a)

Unlike one-and-done programs, your care evolves with your response