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Low B12 levels can lead to weakness and exhaustion
[2] Other conditions giving rise to malabsorption include surgical removal of the stomach, chronic inflammation of the pancreas, intestinal parasites, certain medications such as long-term use of proton pump inhibitors, H2-receptor blockers, and metformin, and some genetic disorders
Vitamin B12 is found almost exclusively in animal products, so if you eat a vegetarian or vegan diet, it can be tough to get enough
Thain A, Hart K, Ahmadi KR European journal of clinical nutrition 2025
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However, a study found that taking 1,000 mcg of B12 by mouth or injecting the vitamin achieved similar results in treating the deficiencies
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