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Common causes include: Pernicious anemia Gastrointestinal disorders Alcoholism Conditions B12 May Prevent or Improve Memory loss, Alzheimers disease, or dementia Fatigue or lack of concentration Weakened immune system Heart, kidney, and liver disease Infertility Osteoporosis Allergies or asthma Tinnitus Skin disorders Lyme disease While oral supplements or nasal gels are alternatives, injections are often necessary for patients with absorption issues

Deficiency of vitamin B 12 (also known as cobalamin), which results in a lack of methylcobalamin, has been associated with significant neurological pathology, especially peripheral neuropathy.(3,4) It is also associated with the onset of diabetic neuropathy

qscience.com Elhadd T, Ponirakis G, Dabbous Z, Siddique M, Chinnaiyan S, Malik RA (2018) Metformin use is not associated with B12 deficiency or neuropathy in patients with type 2 diabetes Mellitus in Qatar

Some notice improved energy within a few days