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B12 injection therapy might offer relief

Lactose or Additives Some B12 supplements contain lactose (in chewable tablets) or artificial sweeteners, which can cause gas in sensitive individuals

For men, it can stimulate testosterone production, which is beneficial for those with low testosterone levels

There are also under the tongue and intranasal methods that can be used once B12 levels are normalized

Some practitioners recommend delaying food intake for 30-60 minutes post-injection to allow the peptides peak effects to occur in the continued fasted state

For example, a cohort of outdoor workers in Indonesia demonstrated significant mean Hb decline of about 1 g/dL by the end of Ramadan compared to non-fasting controls