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In addition, the bioavailability of the vitamin B12 ingested depends on the amount delivered in each dose (Domke et al., 2004)
The tricky thing about fatigue is that its a symptom, not a diagnosis, and it can stem from a multitude of causes: Lifestyle Factors: Poor sleep, chronic stress, insufficient physical activity, or an unhealthy diet can all contribute
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GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord
Additionally, a combination of the two increases antioxidant and anti-inflammatory effects
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