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[1] Specific situations warranting B12 testing include: Persistent unexplained fatigue or weakness Neurological symptoms such as numbness, tingling, or balance problems Cognitive changes or memory difficulties Following a diagnosis of autoimmune conditions (pernicious anaemia often coexists with other autoimmune diseases) Adherence to a strict vegan or vegetarian diet without supplementation Gastrointestinal disorders affecting absorption (Crohn's disease, coeliac disease, previous gastric surgery) Long-term use of medications that interfere with B12 absorption, including metformin (commonly prescribed for type 2 diabetes) and PPIs Unexplained macrocytic anaemia detected on routine blood tests Pregnancy, where prompt treatment of deficiency is important Urgent action is needed if you develop neurological symptoms such as significant paraesthesia, ataxia (poor coordination), gait disturbance, or cognitive changes

Treatment with methionine was stopped, betaine was continued with 250 mg/kg PO and folic acid with 10 mg PO per day

B12 is a water-soluble vitamin vital to various bodily functions, including energy production, red blood cell formation, and nervous system support

Patient #4 A 32-year-old female with a history of a narrow palate, and an open bite with a receded chin had a LeFort I osteotomy 13 years ago

If youre trying the liquid method, you put drops under your tongue instead of ingesting them like you would an oral supplement