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Neomycin, colchicine, para-aminosalicylic acid, or excessive alcohol intake longer than two weeks may cause malabsorption of vitamin B12. Chloramphenicol and other drugs having bone marrow suppressant properties may cause a lack of therapeutic response to vitamin B12

Areas with higher receptor density (such as visceral and abdominal fat) respond more strongly regardless of where the injection occurs

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free-drug occupancy method (albumin Kd 1.86 uM, free fraction 0.29%): Willard JCI Insight 2020

In addition to physical exertion, fatigue can be brought on by conditions like arthritis, anemia, fibromyalgia, chronic fatigue syndrome, colds, flu, eating disorders, sleeping problems, autoimmune disorders, and diabetes

For those diagnosed with a true deficiency , injections might be needed weekly or monthly until levels are normalised, GP surgeries would typically schedule B12 injectsions every 12 weeks thereafter