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When levels are low, it can lead to fatigue, low endurance, and relying on stimulants to get through the day

Heres what we suggest for these patients: Give them high doses of vitamin B12 (1000-2000 mcg) often (daily or weekly) at first Consider Tiaminal B12 injections, which have both thiamine and B12 Watch their symptoms closely and adjust treatment as needed Experts say that High-dose vitamin B12 therapy can lead to significant improvements in neurological function in patients with deficiency-related neuropathy. In short, customizing B12 injection plans for the elderly and those with neurological issues is key

Bariatric surgery is the main example for my patients, but other types of gastrointestinal surgery carry the same risk factors

doi: 10.1182/blood.2021012811 90 SaltarellaIMorabitoFGiulianiNTerragnaCOmedPPalumboAet al