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Internal Medicine Internal Medicine physician with 30+ years focused on metabolic health, nutrition, and deficiency management
According to the NIH Office of Dietary Supplements, functional B12 deficiency is most commonly seen in patients with one or more of the following: Age over 50 stomach acid production declines with age, and stomach acid is required to free B12 from food PPI or H2 blocker use reflux medications suppress the acid needed for B12 absorption Metformin use, which interferes with B12 absorption directly Vegan or vegetarian diets B12 is found almost exclusively in animal products Gut conditions including celiac, IBS, SIBO, and Crohns MTHFR mutations that affect how B12 is metabolized once absorbed Heavy alcohol use The symptoms of low B12 are easy to dismiss: fatigue, brain fog, low mood, tingling in the hands or feet, weakness, and shortness of breath on mild exertion
Evidence-Based Strategy for Sustainable Success Medical weight loss is not about willpower
G.ChackoA
Common Cycle Lengths Most users follow 46 weeks on , followed by 24 weeks off
Improved metabolism : Your body needs B12 to break down food and turn it into energy
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