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Folate levels should be checked concurrently, as folate deficiency can also cause macrocytic anaemia and may coexist with B12 deficiency

Diseases in the final section of the ileum (part of the small intestine), e.g

Well, some people start feeling more energized just a few days after getting their B12 shots for weight loss

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Fermented foods (such as tempeh), nori, spirulina, chlorella algae, and unfortified nutritional yeast cannot be relied upon as adequate or practical sources of B-12.39,40 Vegans must regularly consume reliable sourcesmeaning B-12 fortified foods or B-12 containing supplementsor they could become deficient, as shown in case studies of vegan infants, children, and adults

Handling and use of these products should be restricted to suitably qualified professionals.