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A gut microbiome issue

If a patient is truly deficient and cannot absorb oral B12, injections are lifesaving and the benefits outweigh the small risk

however, common symptoms may include: Strange sensations, numbness, or tingling in the hands, legs, or feet Difficulty walking (staggering, balance problems) Anemia A swollen, inflamed tongue Yellowed skin (jaundice) Difficulty thinking and reasoning (cognitive difficulties), or memory loss Paranoia or hallucinations Weakness Fatigue Signs of Vitamin B12 Deficiency Vitamin-B12 deficiency can manifest in various ways, including fatigue, weakness, constipation, loss of appetite, and weight loss

Who is a good candidate for vitamin B12 injections

2003 Mar;133(3):801-7