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Low B12 levels can cause a number of issues including: Low energy and stamina Sleep disturbances Immune system dysfunction Slow metabolism Mood changes Migraines and headaches Increased chances of heart disease Increased stroke risk Unsteady gait Low blood pressure There are many factors that can cause a drop in B12 levels or a need to increase B12 in the body

Doses greater than 0.4 mg/day should be avoided until the diagnosis of pernicious anemia is ruled out

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These individuals may benefit from supplementation under medical guidance, with monitoring to ensure appropriate dosing and response to treatment