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Nat Rev Immunol, 2018

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Reasons for fatigue Fatigue stems from physical or mental factors, including things like: Metabolic conditions such as diabetes, kidney disease, Cushing syndrome, and thyroid conditions Mental health issues such as depression, stress, eating disorders, anxiety, and burnout Cardiovascular conditions affecting blood flow, such as arrhythmias, heart disease, and heart failure Medications such as antidepressants, antihistamines, steroids, statins, and sedatives Sleep problems due to insomnia, narcolepsy, jet lag, and sleep apnea Chemical imbalances due to too little or too much of various essential nutrients, vitamins, and minerals Facts about B12 deficiency Also referred to as cobalamin deficiency and named after the scientific term for this water-soluble nutrient, a B12 deficiency can result from low dietary intake or from your body not absorbing the vitamin properly

TABLE 1 Causes of vitamin B12 deficiency, classified by cause

Dosing Example: For that same 250mcg dose, the volume is now larger and easier to measure accurately