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Without testing, there is no way to distinguish between B12 deficiency and other causes of similar symptoms, no way to determine the severity of deficiency, and no way to select the most appropriate delivery method
Effect of long-term gastric acid suppressive therapy on serum vitamin B12 levels in patients with Zollinger-Ellison syndrome
In more severe cases, a Vitamin-B deficiency can result in nerve damage, anemia and stomach complications
Additionally, a randomized, double-blind, placebo-controlled trial in 2,588 healthy older adults with mild hyperhomocysteinemia found that daily supplementation with 500 g of vitamin B 12 and 400 g of folic acid for two years reduced blood homocysteine concentrations but had no benefit on depressive symptoms in those with or without depressive symptoms at baseline (110)
