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If your body lacks sufficient B12 due to dietary reasons (e.g., youre vegan and not supplementing) or, more commonly, due to an inability to absorb B12 from your gut (e.g., pernicious anaemia, certain stomach conditions, or medications), then replenishing those levels with an injection will directly address the cause of your fatigue

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Your doctor will typically monitor your response through clinical improvement and blood tests such as full blood count, rather than rechecking B12 levels after starting injections

Taking this diabetes drug might reduce your bodys ability to absorb vitamin B12