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Dietary intake, including vegan or restricted diets and use of fortified foods or supplements
Tony Mangubat and his team can assess your B12 status, identify the root cause of any deficiency, and recommend the treatment approach that matches your individual needs
Anemia is another sign
Frequency depends on your needs
Obesity Pharmacotherapy: Current Perspectives and Future Directions, Misra M., Journal (Current Cardiology Reviews, Volume 9, Issue 1, February 2013, Pages 3354)
Additionally, the body needs sufficient stomach acid for the digestion process to absorb vitamin B12 effectively
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