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Fatigue, Weakness, and Low Energy Perhaps the most common sign of low vitamin B12 is an overwhelming sense of tiredness and weakness

(Youll also need progesterone, which protects your uterus from potential side effects related to supplemental estrogen, unless youve had a hysterectomy.) Some women, especially those still smack in the midst of perimenopause (who thus have even more hormonal roller-coastering than those who are close to menopause) or just entered it, may need more hormonal help and might try birth control pills

This places them at elevated risk for B12 deficiency, and standard oral supplementation may not provide adequate absorption

Leave your main supply refrigerated at home

(1982) examined the contents of three multivitamin preparations and, after incubating them in water at 37C (body temperature) for 2 hours, found that 20% to 90% of the B12 had degraded to inactive analogs