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Common signs include: Fatigue and weakness Numbness or tingling in the hands and feet Difficulty walking or balance problems Mood changes, such as depression or anxiety Cognitive difficulties, including memory loss or confusion If not treated, a B12 deficiency can cause serious problems

This is particularly relevant for oral administration, which is subject to intrinsic factor saturation and receptor limitations in the ileum (Paul and Brady, 2017

It will enhance the safety, comfort, and effectiveness of treatment

A handful of agents on the 503A Bulks List or with a USP monograph , such as glutathione and methylcobalamin (B12)