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However, the enhancement was typically modest and variable, and concerns about intestinal barrier integrity with chronic use limited enthusiasm for this approach

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44 Additionally, in patients who are already taking some form of oral B 12 supplementation, demonstrating B 12 deficiency can be a challenge, even when symptoms are typical (including those of neuropathy-like paraesthesia and numbness) as serum B 12 concentrations may be just within, or sometimes above, the normal range

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Doctors prescribe vitamin B12 shots or B12 pills to increase your vitamin B12 levels particularly if you have severely low levels of vitamin B12 or B12 deficiency