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there may be problems with absorption for various reasons, such as age or medical conditions

Common signs of B12 deficiency include: Persistent fatigue that doesnt improve with rest Difficulty concentrating or brain fog Mood changes, including low mood or irritability Tingling or numbness in the hands and feet Weakness or shortness of breath with normal activity Pale skin or a smooth, swollen tongue B12 deficiency can develop silently for months before symptoms become noticeable, which is why its frequently missed

Studies have shown that although consumption of spirulina and nori temporarily increases the blood serum levels of B12 (although this test does not differentiate B12 analogues), patients MMA levels (metabolic product of B12 and clear indication for its presence) significantly deteriorated (14)