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Think of it like this: a doctor needs an X-ray to confirm a broken bone before putting on a cast

[DOI] [PubMed] [Google Scholar] 213.Rung J.P., Carlsson A., Rydn Markinhuhta K., Carlsson M.L
Estrogen has been shown to upregulate endogenous MOTS-c expression in preclinical models, which may partly explain why metabolic deterioration accelerates in perimenopause when estrogen falls precipitously [2]

Vitamin B-12 deficiency symptoms may include: strange sensations, numbness, or tingling in the hands, legs, or feet difficulty walking (staggering, balance problems) anaemia a swollen, inflamed tongue difficulty thinking and reasoning (cognitive difficulties), or memory loss weakness fatigue While an experienced physician may notice the symptoms and be able to detect a vitamin B-12 deficiency with a good interview and physical exam, a blood test is needed to confirm the condition