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Common signs include: Ongoing fatigue or weakness Pale skin Numbness or tingling in the hands and feet Brain fog, forgetfulness, or trouble concentrating Low mood, anxiety, or irritability Poor appetite or digestive upset When B12 is low, your metabolism slows, you have less energy for activity, and appetite signals can get thrown off, all of which make weight loss harder

Furthermore, some of these non-evidence-based treatments can be downright dangerous

Location And Clinic Type The biggest factor influencing cost is where you are and the type of clinic you choose

Arch Intern Med 166(18):19751979 Campbell JM et al (2018) Metformin use associated with reduced risk of dementia in patients with diabetes: a systematic review and meta-analysis

Certain medications can also hinder B12 absorption , and older adults have a higher likelihood of developing a B12 deficiency